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General NPI Number Information
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NPI Number | 1538952346
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Entity Type | Individual
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Provider Name | KISHAUN S DIXON RBT
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Gender | Female
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Dates
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Enumeration Date | 05/24/2025
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Last Update Date | 09/30/2025
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Provider Practice Location Address
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Address Line | 6309 S HALF MOON DR APT B
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City | BAKERSFIELD
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State | CA
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Zip | 93309-7930
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Country | US
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Telephone | 805-734-7120
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Fax |
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Provider Business Mailing Address
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Address Line | 6309 S HALF MOON DR APT B
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City | BAKERSFIELD
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State | CA
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Zip | 93309-7930
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Country | US
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Telephone | 805-734-7120
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 002535770
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT-25-434028
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License Number State | CA
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