Basic Information
| Provider Information | |||||||||
| NPI: | 1952846529 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TOLENTO | ||||||||
| FirstName: | VIRGINIA | ||||||||
| MiddleName: | JUANITA | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | CAODC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3715 COLUMBUS ST | ||||||||
| Address2: | |||||||||
| City: | BAKERSFIELD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 933062719 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6618687153 | ||||||||
| FaxNumber: | 6618687172 | ||||||||
| Practice Location | |||||||||
| Address1: | 942 S SANTA FE ST | ||||||||
| Address2: | |||||||||
| City: | VISALIA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 932922912 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5596364000 | ||||||||
| FaxNumber: | 5596241067 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/05/2017 | ||||||||
| LastUpdateDate: | 02/20/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | T1404281149 | CA | Y | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) |
No ID Information.