Healthcare Provider Details

I. General information

NPI: 1134032238
Provider Name (Legal Business Name): KERNVILLE HEALTHCARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6504 LAKE ISABELLA BLVD
LAKE ISABELLA CA
93240-9270
US

IV. Provider business mailing address

PO BOX 3085
LAKE ISABELLA CA
93240-3085
US

V. Phone/Fax

Practice location:
  • Phone: 760-549-7971
  • Fax: 760-549-7972
Mailing address:
  • Phone: 760-549-7971
  • Fax: 760-549-7972

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number StateNULL

VIII. Authorized Official

Name: JOEL FRIGILLANA
Title or Position: OWNER
Credential: PHY
Phone: 559-854-7500