Provider Demographics
NPI:1851588875
Name:IBRAHIM, FAITH (REGISTERED NURSE)
Entity Type:Individual
Prefix:
First Name:FAITH
Middle Name:
Last Name:IBRAHIM
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:FAITH
Other - Middle Name:
Other - Last Name:TUBI.
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FAITH TUBI
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:661-868-6601
Mailing Address - Fax:661-868-6666
Practice Address - Street 1:5121 STOCKDALE HWY
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-2656
Practice Address - Country:US
Practice Address - Phone:661-868-5037
Practice Address - Fax:661-868-2605
Is Sole Proprietor?:No
Enumeration Date:2007-10-03
Last Update Date:2020-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95206021163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult