Provider Demographics
NPI:1326516899
Name:SOCIAL STAMINA BEHAVIOR CONSULT SERVICES
Entity type:Organization
Organization Name:SOCIAL STAMINA BEHAVIOR CONSULT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED EDUCATIONAL PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:GINA
Authorized Official - Middle Name:
Authorized Official - Last Name:GORDON-LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:LEP2972
Authorized Official - Phone:661-432-6115
Mailing Address - Street 1:841 MOHAWK ST STE 250
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-1547
Mailing Address - Country:US
Mailing Address - Phone:661-432-6115
Mailing Address - Fax:661-424-7005
Practice Address - Street 1:841 MOHAWK ST STE 250
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-1547
Practice Address - Country:US
Practice Address - Phone:661-432-6115
Practice Address - Fax:661-424-7005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-02
Last Update Date:2025-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Single Specialty