Provider Demographics
NPI:1689024325
Name:CONTRERAS, ERNIE JR
Entity Type:Individual
Prefix:
First Name:ERNIE
Middle Name:
Last Name:CONTRERAS
Suffix:JR
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 1:2005 RIDGE ROAD
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93305
Mailing Address - Country:US
Mailing Address - Phone:661-868-4685
Mailing Address - Fax:661-868-4520
Practice Address - Street 1:2005 RIDGE RD
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93305-4123
Practice Address - Country:US
Practice Address - Phone:661-868-4685
Practice Address - Fax:661-868-4520
Is Sole Proprietor?:No
Enumeration Date:2016-06-14
Last Update Date:2016-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU6017142OtherDRIVER'S LICENSE