Provider Demographics
NPI:1053849950
Name:GUILLEN, JAMI MICHELLE
Entity Type:Individual
Prefix:
First Name:JAMI
Middle Name:MICHELLE
Last Name:GUILLEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 UNION AVE
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93307-1051
Mailing Address - Country:US
Mailing Address - Phone:661-861-6111
Mailing Address - Fax:661-861-6161
Practice Address - Street 1:1100 UNION AVE
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93307-1051
Practice Address - Country:US
Practice Address - Phone:661-861-6111
Practice Address - Fax:661-861-6161
Is Sole Proprietor?:No
Enumeration Date:2017-05-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAR1234131016101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)