Provider Demographics
NPI:1033742606
Name:WIMBERLY, AUBREY EUGENE
Entity Type:Individual
Prefix:
First Name:AUBREY
Middle Name:EUGENE
Last Name:WIMBERLY
Suffix:
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:AUBREY
Other - Middle Name:EUGENE
Other - Last Name:WIMBERLY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1415 TRUXTUN AVE
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301-5215
Mailing Address - Country:US
Mailing Address - Phone:661-868-4595
Mailing Address - Fax:661-868-4520
Practice Address - Street 1:1415 TRUXTUN AVE
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-5215
Practice Address - Country:US
Practice Address - Phone:661-868-4595
Practice Address - Fax:661-868-4520
Is Sole Proprietor?:No
Enumeration Date:2020-02-21
Last Update Date:2020-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator