Healthcare Provider Details

I. General information

NPI: 1922601897
Provider Name (Legal Business Name): KERN BRIDGES YOUTH HOMES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2020
Last Update Date: 10/24/2024
Certification Date: 10/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4301 DE ETTE AVE
BAKERSFIELD CA
93313-2916
US

IV. Provider business mailing address

1321 STINE RD
BAKERSFIELD CA
93309-4176
US

V. Phone/Fax

Practice location:
  • Phone: 661-827-9219
  • Fax: 661-827-9221
Mailing address:
  • Phone: 661-396-2361
  • Fax: 661-396-2349

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code322D00000X
TaxonomyEmotionally Disturbed Childrens' Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: WILLIAM JAMES VANDERZWAN
Title or Position: CEO
Credential:
Phone: 661-396-2301