Provider Demographics
NPI:1316725385
Name:NEARING, RODERICK (LICENSED VOCATIONAL)
Entity type:Individual
Prefix:
First Name:RODERICK
Middle Name:
Last Name:NEARING
Suffix:
Gender:M
Credentials:LICENSED VOCATIONAL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10109 PALM AVE
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93312-2857
Mailing Address - Country:US
Mailing Address - Phone:805-816-9675
Mailing Address - Fax:
Practice Address - Street 1:1010 1/2 S UNION AVE
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93307-3642
Practice Address - Country:US
Practice Address - Phone:661-321-0234
Practice Address - Fax:661-321-9856
Is Sole Proprietor?:No
Enumeration Date:2023-09-20
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA727841164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse