Provider Demographics
NPI:1790172104
Name:JERI YVONNE MOVEMENT DISORDERS NEUROLOGY INC.
Entity type:Organization
Organization Name:JERI YVONNE MOVEMENT DISORDERS NEUROLOGY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JERI
Authorized Official - Middle Name:YVONNE
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:661-679-3590
Mailing Address - Street 1:8327 BRIMHALL RD STE 703
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93312-2250
Mailing Address - Country:US
Mailing Address - Phone:661-679-3590
Mailing Address - Fax:661-695-6900
Practice Address - Street 1:8327 BRIMHALL RD STE 703
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93312-2250
Practice Address - Country:US
Practice Address - Phone:661-679-3590
Practice Address - Fax:661-695-6900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-23
Last Update Date:2024-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty