Provider Demographics
NPI:1649305194
Name:RHODES, BEVERLY LENN (A8390501)
Entity type:Individual
Prefix:MS
First Name:BEVERLY
Middle Name:LENN
Last Name:RHODES
Suffix:
Gender:F
Credentials:A8390501
Other - Prefix:MS
Other - First Name:BEVERLY
Other - Middle Name:LENN
Other - Last Name:RHODES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:A8390501
Mailing Address - Street 1:PO BOX 3218
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93385-3218
Mailing Address - Country:US
Mailing Address - Phone:661-246-3180
Mailing Address - Fax:666-163-3991
Practice Address - Street 1:3316 LAVERNE AVE
Practice Address - Street 2:3316 LAVERNE AVENUE
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-4082
Practice Address - Country:US
Practice Address - Phone:661-832-8504
Practice Address - Fax:661-827-9432
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2019-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101YA0400X
101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)