=====================================================
General NPI Number Information
=====================================================
NPI Number | 1447741632
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | KERN COUNTY PROBATION DEPARTMENT
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/23/2018
-----------------------------------------------------
Last Update Date | 06/03/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2005 RIDGE ROAD
-----------------------------------------------------
City | BAKERSFIELD
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93305
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 661-868-4100
-----------------------------------------------------
Fax | 661-868-4186
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | P.O. BOX 3309
-----------------------------------------------------
City | BAKERSFIELD
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93385
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 661-868-4100
-----------------------------------------------------
Fax | 661-868-4186
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CHIEF PROBATION OFFICER
-----------------------------------------------------
Name | WILLIAM P DICKINSON
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 661-868-4102
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 171000000X
-----------------------------------------------------
Taxonomy Name | Military Health Care Provider
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------