Provider Demographics
NPI:1285865022
Name:OBERG, MIKELA
Entity Type:Individual
Prefix:MR
First Name:MIKELA
Middle Name:
Last Name:OBERG
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 1:508 PANAMA RD
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93307-6229
Mailing Address - Country:US
Mailing Address - Phone:661-831-9256
Mailing Address - Fax:
Practice Address - Street 1:18200 HIGHWAY 178
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93306-9510
Practice Address - Country:US
Practice Address - Phone:661-871-9697
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-28
Last Update Date:2009-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health