Provider Demographics
NPI:1871789289
Name:LIVESAY, FELISHA M
Entity type:Individual
Prefix:
First Name:FELISHA
Middle Name:M
Last Name:LIVESAY
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 1:1001 TOWER WAY
Mailing Address - Street 2:# 110
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-1597
Mailing Address - Country:US
Mailing Address - Phone:661-323-1233
Mailing Address - Fax:
Practice Address - Street 1:1001 TOWER WAY
Practice Address - Street 2:# 110
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-1597
Practice Address - Country:US
Practice Address - Phone:661-323-1233
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-19
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
CALCSW87576101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor