Healthcare Provider Details

I. General information

NPI: 1609179431
Provider Name (Legal Business Name): KERN COUNTY MENTAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2010
Last Update Date: 12/16/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5121 STOCKDALE HWY STE 275 5121 STOCKDALE HWY SUITE #275
BAKERSFIELD CA
93309-2667
US

IV. Provider business mailing address

5121 STOCKDALE HWY STE 275 5121 STOCKDALE HWY SUITE #275
BAKERSFIELD CA
93309-2667
US

V. Phone/Fax

Practice location:
  • Phone: 661-868-5004
  • Fax: 661-836-8834
Mailing address:
  • Phone: 661-868-5004
  • Fax: 661-836-8834

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 Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateCA

VIII. Authorized Official

Name: MRS. DOROTHY LOU JONES
Title or Position: RECOVERY SPECIALIST II
Credential:
Phone: 661-868-5004