Healthcare Provider Details

I. General information

NPI: 1194195735
Provider Name (Legal Business Name): KERN COUNTY DEPARMENT OF MENTAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2015
Last Update Date: 09/25/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5121 STOCKDALE HWY SUITE 275
BAKERSFIELD CA
93309-2656
US

IV. Provider business mailing address

PO BOX 1000
BAKERSFIELD CA
93302-1000
US

V. Phone/Fax

Practice location:
  • Phone: 661-868-5000
  • Fax: 661-836-8834
Mailing address:
  • Phone: 661-868-5000
  • Fax: 661-836-8834

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. PEG WALKER
Title or Position: UNIT SUPERVISOR
Credential: LCSW
Phone: 661-868-5050