Healthcare Provider Details

I. General information

NPI: 1467217083
Provider Name (Legal Business Name): KERN PSYCHIATRIC HEALTH AND WELLNESS CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2024
Last Update Date: 02/06/2025
Certification Date: 02/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2204 Q ST STE B
BAKERSFIELD CA
93301-2946
US

IV. Provider business mailing address

PO BOX 10748
BAKERSFIELD CA
93389-0748
US

V. Phone/Fax

Practice location:
  • Phone: 661-323-6410
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251X00000X
TaxonomySupports Brokerage Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ROGELIO MONZON
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 602-509-2301