Provider Demographics
NPI:1427795822
Name:MOLINA, NEIDA JESUS
Entity type:Individual
Prefix:
First Name:NEIDA
Middle Name:JESUS
Last Name:MOLINA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3309
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93385-3309
Mailing Address - Country:US
Mailing Address - Phone:661-720-5832
Mailing Address - Fax:
Practice Address - Street 1:1122 JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:DELANO
Practice Address - State:CA
Practice Address - Zip Code:93215-2241
Practice Address - Country:US
Practice Address - Phone:661-720-5832
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-17
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator