Healthcare Provider Details

I. General information

NPI: 1346151461
Provider Name (Legal Business Name): KRISTEN KERNAGHAN PPSC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31800 ROAD 400
COARSEGOLD CA
93614-9040
US

IV. Provider business mailing address

31800 ROAD 400
COARSEGOLD CA
93614-9040
US

V. Phone/Fax

Practice location:
  • Phone: 559-683-7566
  • Fax: 559-658-7244
Mailing address:
  • Phone: 559-683-7566
  • Fax: 559-658-7244

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: