Basic Information
Provider Information
NPI: 1952574741
EntityType: 2
ReplacementNPI:  
OrganizationName: KERN COUNTY MENTAL HEALTH
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
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Mailing Information
Address1: PO BOX 1000
Address2:  
City: BAKERSFIELD
State: CA
PostalCode: 933021000
CountryCode: US
TelephoneNumber: 6616352950
FaxNumber: 6616352983
Practice Location
Address1: 1600 E BELLE TER
Address2:  
City: BAKERSFIELD
State: CA
PostalCode: 933073880
CountryCode: US
TelephoneNumber: 6616352950
FaxNumber: 6616352983
Other Information
ProviderEnumerationDate: 04/11/2008
LastUpdateDate: 04/11/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: DAVIE-HAYNES
AuthorizedOfficialFirstName: MELANIE
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: UNIT SUPERVISOR
AuthorizedOfficialTelephone: 6616352952
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: MRS.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: LCSW
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
323P00000XNONE Y Residential Treatment FacilitiesPsychiatric Residential Treatment Facility 

No ID Information.


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