Provider Demographics
NPI:1992008643
Name:KERN COUNTY PUBLIC HEALTH DEPARTMENT
Entity Type:Organization
Organization Name:KERN COUNTY PUBLIC HEALTH DEPARTMENT
Other - Org Name:CALIFORNIA CHILDRENS SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:PHN I
Authorized Official - Prefix:MRS
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:WILLIAMS
Authorized Official - Last Name:PITRE
Authorized Official - Suffix:
Authorized Official - Credentials:BSN
Authorized Official - Phone:661-868-0206
Mailing Address - Street 1:1800 MT VERNON AVE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93306
Mailing Address - Country:US
Mailing Address - Phone:661-868-0531
Mailing Address - Fax:661-868-0266
Practice Address - Street 1:1800 MOUNT VERNON AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93306-3302
Practice Address - Country:US
Practice Address - Phone:661-868-0531
Practice Address - Fax:661-868-0266
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-17
Last Update Date:2010-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA619184251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare