Provider Demographics
NPI:1235554056
Name:ADVANCED PSYCHOLOGICAL PRESCRIPTIVES
Entity Type:Organization
Organization Name:ADVANCED PSYCHOLOGICAL PRESCRIPTIVES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:VANESSA
Authorized Official - Middle Name:
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, MSN,PMHNP-BC
Authorized Official - Phone:661-283-5790
Mailing Address - Street 1:1300 TORULOSA DR
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93311-9328
Mailing Address - Country:US
Mailing Address - Phone:661-283-5790
Mailing Address - Fax:
Practice Address - Street 1:4900 CALIFORNIA AVE
Practice Address - Street 2:TOWER B, SUITE 210
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-7024
Practice Address - Country:US
Practice Address - Phone:661-283-5790
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-03
Last Update Date:2014-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20809NPF261QM0850X
CANPF20809261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health