Provider Demographics
NPI:1831364413
Name:POPOVICH, STEVEN CLARK
Entity type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:CLARK
Last Name:POPOVICH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5104 SUMMERWIND WAY
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93308-6534
Mailing Address - Country:US
Mailing Address - Phone:661-213-6204
Mailing Address - Fax:
Practice Address - Street 1:5104 SUMMERWIND WAY
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93308-6534
Practice Address - Country:US
Practice Address - Phone:661-213-6204
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-24
Last Update Date:2008-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health