Healthcare Provider Details

I. General information

NPI: 1285168518
Provider Name (Legal Business Name): COUNTY OF KERN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2017
Last Update Date: 04/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 DRUMMOND AVE
RIDGECREST CA
93555-3118
US

IV. Provider business mailing address

PO BOX 1000
BAKERSFIELD CA
93302-1000
US

V. Phone/Fax

Practice location:
  • Phone: 661-868-6601
  • Fax:
Mailing address:
  • Phone: 661-868-6601
  • Fax: 661-861-1020

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. WILLIAM P WALKER
Title or Position: DIRECTOR
Credential: LMFT
Phone: 661-868-6601