Provider Demographics
NPI:1770390825
Name:PAIGE, VICKY
Entity type:Individual
Prefix:
First Name:VICKY
Middle Name:
Last Name:PAIGE
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5080 CALIFORNIA AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-0794
Mailing Address - Country:US
Mailing Address - Phone:661-634-9877
Mailing Address - Fax:
Practice Address - Street 1:5080 CALIFORNIA AVE STE 100
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-0794
Practice Address - Country:US
Practice Address - Phone:661-634-9877
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-12
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)