Provider Demographics
NPI:1679795827
Name:FARMER, KEVEN LAVELL I
Entity Type:Individual
Prefix:MR
First Name:KEVEN
Middle Name:LAVELL
Last Name:FARMER
Suffix:I
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43425 BALE CT
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93535-4981
Mailing Address - Country:US
Mailing Address - Phone:661-946-8535
Mailing Address - Fax:
Practice Address - Street 1:43423 DIVISION ST
Practice Address - Street 2:107
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93535-4639
Practice Address - Country:US
Practice Address - Phone:661-726-2850
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered171M00000XOther Service ProvidersCase Manager/Care Coordinator
Not Answered225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner