Healthcare Provider Details

I. General information

NPI: 1740078682
Provider Name (Legal Business Name): KERN COUNTY BRAIN INJURY FOUNDATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2025
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2105 24TH ST STE 100
BAKERSFIELD CA
93301-3753
US

IV. Provider business mailing address

2105 24TH ST STE 100
BAKERSFIELD CA
93301-3753
US

V. Phone/Fax

Practice location:
  • Phone: 661-369-7293
  • Fax: 661-344-4266
Mailing address:
  • Phone: 661-369-7293
  • Fax: 661-344-4266

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. ADONICA N VICKERS
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 661-378-3764