Provider Demographics
NPI:1164868576
Name:ACOSTA, VERONICA JANETTE
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:JANETTE
Last Name:ACOSTA
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 1:1400 S UNION AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93307-4179
Mailing Address - Country:US
Mailing Address - Phone:661-397-8775
Mailing Address - Fax:661-397-8286
Practice Address - Street 1:1400 S UNION AVE STE 100
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93307-4179
Practice Address - Country:US
Practice Address - Phone:661-397-8775
Practice Address - Fax:661-397-8286
Is Sole Proprietor?:No
Enumeration Date:2013-05-13
Last Update Date:2014-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator