Provider Demographics
NPI:1053075861
Name:AFFINITY FAMILY WELLNESS AND THERAPY, A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:AFFINITY FAMILY WELLNESS AND THERAPY, A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ALEXIS
Authorized Official - Middle Name:
Authorized Official - Last Name:BIRD
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:661-484-0079
Mailing Address - Street 1:5405 STOCKDALE HIGHWAY, SUITE 202
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309
Mailing Address - Country:US
Mailing Address - Phone:661-484-0079
Mailing Address - Fax:661-564-8546
Practice Address - Street 1:5405 STOCKDALE HIGHWAY, SUITE 202
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309
Practice Address - Country:US
Practice Address - Phone:661-484-0079
Practice Address - Fax:661-564-8546
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-27
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty