Healthcare Provider Details

I. General information

NPI: 1861316069
Provider Name (Legal Business Name): MISS K'S HOUSING AND WELLNESS FOUNDATION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6904 BLAZE ROSE ST
BAKERSFIELD CA
93313-5576
US

IV. Provider business mailing address

3911 CLEVELAND AVE # 33748
SAN DIEGO CA
92103-3402
US

V. Phone/Fax

Practice location:
  • Phone: 661-301-5707
  • Fax:
Mailing address:
  • Phone: 661-301-5707
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: KRISPEN J MALONE
Title or Position: PRESIDENT/CEO
Credential:
Phone: 661-301-5707