Provider Demographics
NPI:1376224386
Name:MENCHACA, STEVE (RN, VA-BC)
Entity Type:Individual
Prefix:
First Name:STEVE
Middle Name:
Last Name:MENCHACA
Suffix:
Gender:M
Credentials:RN, VA-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15830 SANTA CLARA CT
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93314-4842
Mailing Address - Country:US
Mailing Address - Phone:661-932-5854
Mailing Address - Fax:
Practice Address - Street 1:15830 SANTA CLARA CT
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93314-4842
Practice Address - Country:US
Practice Address - Phone:661-932-5854
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-31
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA776875163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice