Healthcare Provider Details
I. General information
NPI: 1699282285
Provider Name (Legal Business Name): KERN COUNTY HOSPITAL AUTHORITY
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/04/2018
Last Update Date: 05/11/2023
Certification Date: 05/11/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6001 TRUXTUN AVE STE 210
BAKERSFIELD CA
93309-0662
US
IV. Provider business mailing address
1700 MOUNT VERNON AVE
BAKERSFIELD CA
93306-4018
US
V. Phone/Fax
- Phone: 661-326-2000
- Fax:
- Phone: 661-326-2000
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208D00000X |
| Taxonomy | General Practice Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 282N00000X |
| Taxonomy | General Acute Care Hospital |
| License Number | 120000182 |
| License Number State | CA |
VIII. Authorized Official
Name:
RENEE
VILLANUEVA
Title or Position: VP AMBULATORY SERVICES
Credential:
Phone: 661-326-2682