Provider Demographics
NPI:1538442009
Name:KIRKPATRICK, GLENDORA LOUISE
Entity type:Individual
Prefix:MS
First Name:GLENDORA
Middle Name:LOUISE
Last Name:KIRKPATRICK
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 1:1400 EASTON DR
Mailing Address - Street 2:SUITE 151
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-9412
Mailing Address - Country:US
Mailing Address - Phone:661-634-9737
Mailing Address - Fax:661-634-9737
Practice Address - Street 1:1400 EASTON DRIVE
Practice Address - Street 2:SUITE 151
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309
Practice Address - Country:US
Practice Address - Phone:661-634-9737
Practice Address - Fax:661-634-9737
Is Sole Proprietor?:No
Enumeration Date:2011-09-21
Last Update Date:2015-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACERT A8393302101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1821269382OtherDRUG AND ALCOHOL SERVICES