Provider Demographics
NPI:1124805643
Name:GALVAN, PRISCILLA
Entity type:Individual
Prefix:
First Name:PRISCILLA
Middle Name:
Last Name:GALVAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:PRISCILLA
Other - Middle Name:
Other - Last Name:CORVERA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3628 STOCKDALE HWY
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-2153
Mailing Address - Country:US
Mailing Address - Phone:661-322-1021
Mailing Address - Fax:661-322-7334
Practice Address - Street 1:3628 STOCKDALE HWY
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-2153
Practice Address - Country:US
Practice Address - Phone:661-322-1021
Practice Address - Fax:661-322-7334
Is Sole Proprietor?:No
Enumeration Date:2023-09-08
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker