NPI 1245050897

Mike Herrera

Practitioner Prevention Professional Baker, CA

Practice location

Address: 57131 Lakeview Rd, Baker, CA 92309
Phone: (909) 389-8582
Mailing address: 1366 Whitewood Dr, Mentone, CA 92359-1623

Registered specialties

Prevention Professional Primary

Other Service Providers Taxonomy 405300000X Licence 360159AP (CA)

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Registry record

NPI: 1245050897
Entity type: Individual
Sex (as registered): Male
NPI issued: 16 Oct 2024
Record last updated: 16 Oct 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.