Provider Demographics
NPI:1477933794
Name:MADZIARSKI, SAMANTHA CASSANDRA (MD)
Entity Type:Individual
Prefix:DR
First Name:SAMANTHA
Middle Name:CASSANDRA
Last Name:MADZIARSKI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1000
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93302-1000
Mailing Address - Country:US
Mailing Address - Phone:661-326-5411
Mailing Address - Fax:661-862-7682
Practice Address - Street 1:1600 E BELLE TER
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93307-3871
Practice Address - Country:US
Practice Address - Phone:661-868-8037
Practice Address - Fax:661-868-8081
Is Sole Proprietor?:No
Enumeration Date:2015-06-02
Last Update Date:2021-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1503222084P0800X
CA390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program