Provider Demographics
NPI:1588991202
Name:WITT, ROSIE STEVENS
Entity type:Individual
Prefix:
First Name:ROSIE
Middle Name:STEVENS
Last Name:WITT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ROSEIE
Other - Middle Name:
Other - Last Name:WITT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MFT
Mailing Address - Street 1:900 H ST
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93304-1312
Mailing Address - Country:US
Mailing Address - Phone:661-325-1630
Mailing Address - Fax:661-395-0372
Practice Address - Street 1:900 H ST
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93304-1312
Practice Address - Country:US
Practice Address - Phone:661-325-1630
Practice Address - Fax:661-395-0372
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-17
Last Update Date:2009-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC35123101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional