Healthcare Provider Details

I. General information

NPI: 1407971518
Provider Name (Legal Business Name): COUNTY OF KERN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 COLUMBUS ST SUITE 5000
BAKERSFIELD CA
93305-1936
US

IV. Provider business mailing address

1830 FLOWER ST
BAKERSFIELD CA
93305-4144
US

V. Phone/Fax

Practice location:
  • Phone: 661-326-6598
  • Fax: 661-326-6593
Mailing address:
  • Phone: 661-326-2102
  • Fax: 661-326-2100

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number StateCA

VIII. Authorized Official

Name: MR. DAVID CULBERSON
Title or Position: INERIM CEO
Credential:
Phone: 661-326-2102