Provider Demographics
NPI:1528347994
Name:MUNDSCHAU, SOFI JANE
Entity type:Individual
Prefix:
First Name:SOFI
Middle Name:JANE
Last Name:MUNDSCHAU
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 1:12609 MAUNA LOA AVE
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93312-5421
Mailing Address - Country:US
Mailing Address - Phone:661-742-6541
Mailing Address - Fax:
Practice Address - Street 1:3715 COLUMBUS ST
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93306-2719
Practice Address - Country:US
Practice Address - Phone:661-868-7182
Practice Address - Fax:661-872-6001
Is Sole Proprietor?:No
Enumeration Date:2011-08-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator