Healthcare Provider Details

I. General information

NPI: 1548715063
Provider Name (Legal Business Name): KERN COUNTY HOSPITAL AUTHORITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2016
Last Update Date: 02/06/2025
Certification Date: 02/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9300 STOCKDALE HWY STE 300
BAKERSFIELD CA
93311-3611
US

IV. Provider business mailing address

1700 MOUNT VERNON AVE RM 1241
BAKERSFIELD CA
93306-4018
US

V. Phone/Fax

Practice location:
  • Phone: 661-664-2200
  • Fax: 661-664-2202
Mailing address:
  • Phone: 661-326-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number120000182
License Number StateCA

VIII. Authorized Official

Name: RENEE VILLANUEVA
Title or Position: CHIEF AMBULATORY OFFICER
Credential:
Phone: 661-326-2682