Provider Demographics
NPI:1003257841
Name:MITCHELL, LATOYA MARIE
Entity type:Individual
Prefix:MRS
First Name:LATOYA
Middle Name:MARIE
Last Name:MITCHELL
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 1:100 OLD RIVER RD STE 150
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93311-8334
Mailing Address - Country:US
Mailing Address - Phone:661-855-7455
Mailing Address - Fax:
Practice Address - Street 1:100 OLD RIVER RD STE 150
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93311-8334
Practice Address - Country:US
Practice Address - Phone:661-855-7455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-09
Last Update Date:2025-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CAR1290740218101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program