Healthcare Provider Details

I. General information

NPI: 1528553328
Provider Name (Legal Business Name): KERN BEHAVIORAL HEALTH & RECOVERY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2018
Last Update Date: 06/25/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5121 STOCKDALE HWY STE 275
BAKERSFIELD CA
93309-2667
US

IV. Provider business mailing address

5121 STOCKDALE HWY STE 275
BAKERSFIELD CA
93309-2667
US

V. Phone/Fax

Practice location:
  • Phone: 661-868-5000
  • Fax:
Mailing address:
  • Phone: 661-868-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name: MR. RODRIGO GARCIA-AGREDANO
Title or Position: RECOVERY SPECIALIST
Credential: BA
Phone: 661-868-5141