Healthcare Provider Details

I. General information

NPI: 1609384551
Provider Name (Legal Business Name): CHILDNET YOUTH AND FAMILY SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/12/2018
Last Update Date: 05/27/2025
Certification Date: 05/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2131 MARS CT
BAKERSFIELD CA
93308-6830
US

IV. Provider business mailing address

3545 LONG BEACH BLVD FL 5
LONG BEACH CA
90807-3968
US

V. Phone/Fax

Practice location:
  • Phone: 661-633-1700
  • Fax:
Mailing address:
  • Phone: 562-498-5500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name: MRS. WENDY FIES
Title or Position: CONTROLLER
Credential: DO
Phone: 562-498-5513