Basic Information
| Provider Information | |||||||||
| NPI: | 1194195735 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | KERN COUNTY DEPARMENT OF MENTAL HEALTH | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1000 | ||||||||
| Address2: | |||||||||
| City: | BAKERSFIELD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 933021000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6618685000 | ||||||||
| FaxNumber: | 6618368834 | ||||||||
| Practice Location | |||||||||
| Address1: | 5121 STOCKDALE HWY | ||||||||
| Address2: | SUITE 275 | ||||||||
| City: | BAKERSFIELD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 933092656 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6618685000 | ||||||||
| FaxNumber: | 6618368834 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/25/2015 | ||||||||
| LastUpdateDate: | 09/25/2015 | ||||||||
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| AuthorizedOfficialLastName: | WALKER | ||||||||
| AuthorizedOfficialFirstName: | PEG | ||||||||
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| AuthorizedOfficialTitleorPosition: | UNIT SUPERVISOR | ||||||||
| AuthorizedOfficialTelephone: | 6618685050 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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| AuthorizedOfficialCredential: | LCSW | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | Y | Agencies | Community/Behavioral Health |
No ID Information.