Basic Information
| Provider Information | |||||||||
| NPI: | 1497094254 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KUCHARSKI | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | AARON | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1000 | ||||||||
| Address2: | |||||||||
| City: | BAKERSFIELD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 933021000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6618686601 | ||||||||
| FaxNumber: | 6618686666 | ||||||||
| Practice Location | |||||||||
| Address1: | 2525 N CHESTER AVE | ||||||||
| Address2: | |||||||||
| City: | BAKERSFIELD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 933081770 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6618681842 | ||||||||
| FaxNumber: | 6618681841 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/13/2013 | ||||||||
| LastUpdateDate: | 02/16/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/16/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 171M00000X | N | Other Service Providers | Case Manager/Care Coordinator | 101YA0400X | RW6823 | CA | N | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | 101YA0400X | A051910720 | CA | Y | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) |
No ID Information.