Provider Demographics
NPI:1861386153
Name:BACARRO, BRYCE
Entity type:Individual
Prefix:
First Name:BRYCE
Middle Name:
Last Name:BACARRO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5121 STOCKDALE HWY STE 212
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-2664
Mailing Address - Country:US
Mailing Address - Phone:661-473-1500
Mailing Address - Fax:
Practice Address - Street 1:5121 STOCKDALE HWY STE 212
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-2664
Practice Address - Country:US
Practice Address - Phone:661-473-1500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-03
Last Update Date:2025-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1093540767OtherTELECARE KERN FSP