Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 103718 | CA |
NPI | 1013575240 |
---|---|
Provider Name | Dr. Jessica Anne Mahlmann |
First Address | Bakersfield, CA 93311-9122 |
Second Address | Bakersfield, CA 93308-5079 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/06/2019 |
Last Update Date | 22/08/2019 |