Basic Information
| Provider Information | |||||||||
| NPI: | 1487004404 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | KERN COUNTY MENTAL HEALTH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1415 TRUXTUN AVE | ||||||||
| Address2: | |||||||||
| City: | BAKERSFIELD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 933015215 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6618686932 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2621 OSWELL ST | ||||||||
| Address2: | 119 | ||||||||
| City: | BAKERSFIELD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 933063172 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6618686750 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/21/2016 | ||||||||
| LastUpdateDate: | 06/21/2016 | ||||||||
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| AuthorizedOfficialLastName: | ACOSTA | ||||||||
| AuthorizedOfficialFirstName: | YSIDORA S | ||||||||
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| AuthorizedOfficialTitleorPosition: | OFFICE SERVICES TECHNICIAN | ||||||||
| AuthorizedOfficialTelephone: | 6618686932 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251B00000X | CA | N | Agencies | Case Management | 261QM0855X | CA | N | Ambulatory Health Care Facilities | Clinic/Center | Adolescent and Children Mental Health | 251V00000X | CA | Y | Agencies | Voluntary or Charitable |
No ID Information.