Basic Information
| Provider Information | |||||||||
| NPI: | 1366818676 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PARRA | ||||||||
| FirstName: | PERLA | ||||||||
| MiddleName: | |||||||||
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| Credential: | LCSW | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 2400 WIBLE RD STE 14 | ||||||||
| Address2: | |||||||||
| City: | BAKERSFIELD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 933044734 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6618351240 | ||||||||
| FaxNumber: | 6618354667 | ||||||||
| Practice Location | |||||||||
| Address1: | 2400 WIBLE RD STE 14 | ||||||||
| Address2: | |||||||||
| City: | BAKERSFIELD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 933044734 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6618351240 | ||||||||
| FaxNumber: | 6618354667 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/20/2015 | ||||||||
| LastUpdateDate: | 02/24/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
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| NPICertificationDate: | 02/24/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 93133 | CA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.