Provider Demographics
NPI:1306035480
Name:PADILLA, JESUS E (BA)
Entity Type:Individual
Prefix:MR
First Name:JESUS
Middle Name:E
Last Name:PADILLA
Suffix:
Gender:M
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4551 CALIFORNIA AVE
Mailing Address - Street 2:APT. 5
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-1121
Mailing Address - Country:US
Mailing Address - Phone:661-472-7225
Mailing Address - Fax:
Practice Address - Street 1:4551 CALIFORNIA AVE
Practice Address - Street 2:APT. 5
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-1121
Practice Address - Country:US
Practice Address - Phone:661-472-7225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-15
Last Update Date:2007-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)