Provider Demographics
NPI:1336290345
Name:NUNEZ, ANNETTE OLVERA (CASE MANAGER)
Entity Type:Individual
Prefix:MISS
First Name:ANNETTE
Middle Name:OLVERA
Last Name:NUNEZ
Suffix:
Gender:F
Credentials:CASE MANAGER
Other - Prefix:
Other - First Name:ANNETTE
Other - Middle Name:OLVERA
Other - Last Name:BALTAZAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CASE MANAGER
Mailing Address - Street 1:PO BOX 1559
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93302-1559
Mailing Address - Country:US
Mailing Address - Phone:661-397-8775
Mailing Address - Fax:661-617-2098
Practice Address - Street 1:2731 NUGGET AVE
Practice Address - Street 2:
Practice Address - City:LAKE ISABELLA
Practice Address - State:CA
Practice Address - Zip Code:93240-9456
Practice Address - Country:US
Practice Address - Phone:760-463-5028
Practice Address - Fax:760-379-5332
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2019-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
CA13627101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator