MEDICARE: JOSIAH BENTON KRANTZ MA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number State
1	103T00000X	Psychologist
2	373H00000X	Day Training/Habilitation Specialist	CA
3	171M00000X	Case Manager/Care Coordinator
4	390200000X	Student in an Organized Health Care Education/Training Program	CA

General Provider Information

NPI Number	:	1033825823
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSIAH BENTON KRANTZ MA

Provider Business Mailing Address
First Line	:	3117 WILSON RD
Second Line	:
City	:	BAKERSFIELD
State	:	CA
Zip	:	93304-5319
Country	:	US
Telephone Number	:	661-324-4756
Fax Number	:

Provider Business Practice Location Address
First Line	:	3117 WILSON RD
Second Line	:
City	:	BAKERSFIELD
State	:	CA
Zip	:	93304-5319
Country	:	US
Telephone Number	:	661-324-4756
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/25/2023
Last Update Date	:	05/07/2026

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