Provider Demographics
NPI:1255501912
Name:HARBERT, CEDRIC (LVN)
Entity Type:Individual
Prefix:MR
First Name:CEDRIC
Middle Name:
Last Name:HARBERT
Suffix:
Gender:M
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1505 WELLS AVE # C
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93308-2410
Mailing Address - Country:US
Mailing Address - Phone:661-675-6770
Mailing Address - Fax:
Practice Address - Street 1:1505 WELLS AVE # C
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93308-2410
Practice Address - Country:US
Practice Address - Phone:661-675-6770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-08
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA207368164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
1255501912OtherHARBERT NURSING & PERSONAL CARE SERVICES