Basic Information
| Provider Information | |||||||||
| NPI: | 1023147048 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RUFUS | ||||||||
| FirstName: | DERRICK | ||||||||
| MiddleName: | CURTIS | ||||||||
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| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 930 TRUXTUN AVE STE 108 | ||||||||
| Address2: | |||||||||
| City: | BAKERSFIELD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 933014700 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6613982981 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2525 N CHESTER AVE | ||||||||
| Address2: | |||||||||
| City: | BAKERSFIELD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 933081770 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6618681842 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/05/2007 | ||||||||
| LastUpdateDate: | 10/10/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/10/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 83405 | CA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.