Provider Demographics
NPI:1720620420
Name:MEDRANO, MARIA CARMEN
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:CARMEN
Last Name:MEDRANO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2621 OSWELL ST STE 119
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93306-3172
Mailing Address - Country:US
Mailing Address - Phone:661-868-8675
Mailing Address - Fax:661-872-3001
Practice Address - Street 1:2621 OSWELL ST STE 119
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93306-3172
Practice Address - Country:US
Practice Address - Phone:661-868-6750
Practice Address - Fax:661-872-3001
Is Sole Proprietor?:No
Enumeration Date:2019-10-14
Last Update Date:2019-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide