Provider Demographics
NPI:1912231598
Name:MULLEN, RYAN PATRICK
Entity Type:Individual
Prefix:MR
First Name:RYAN
Middle Name:PATRICK
Last Name:MULLEN
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 1:1001 TOWER WAY
Mailing Address - Street 2:SUITE 110
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-1597
Mailing Address - Country:US
Mailing Address - Phone:661-859-2135
Mailing Address - Fax:661-323-1302
Practice Address - Street 1:1001 TOWER WAY
Practice Address - Street 2:SUITE 110
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-1597
Practice Address - Country:US
Practice Address - Phone:661-859-2135
Practice Address - Fax:661-323-1302
Is Sole Proprietor?:No
Enumeration Date:2009-09-29
Last Update Date:2011-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health