Provider Demographics
NPI:1336671726
Name:JAMES, DENISE ROBERTS
Entity Type:Individual
Prefix:MRS
First Name:DENISE
Middle Name:ROBERTS
Last Name:JAMES
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 1:10931 SHELLABARGER ROAD
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93312
Mailing Address - Country:US
Mailing Address - Phone:661-333-7466
Mailing Address - Fax:661-588-7217
Practice Address - Street 1:10931 SHELLABARGER RD
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93312-2866
Practice Address - Country:US
Practice Address - Phone:661-333-7466
Practice Address - Fax:661-588-7217
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-03
Last Update Date:2017-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT95229106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist