1548396187 NPI number — KERN COUNTY HISPANIC COMMISSION ON ALCOHOL AND DRUG ABUSE SERVICES INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1548396187 NPI number — KERN COUNTY HISPANIC COMMISSION ON ALCOHOL AND DRUG ABUSE SERVICES INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
KERN COUNTY HISPANIC COMMISSION ON ALCOHOL AND DRUG ABUSE SERVICES INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1548396187
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/26/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1131 S H ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BAKERSFIELD
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93304-3909
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
661-634-9737
Provider Business Mailing Address Fax Number:
661-864-0198

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1131 S H ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BAKERSFIELD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93304-3909
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-634-9737
Provider Business Practice Location Address Fax Number:
661-864-0198
Provider Enumeration Date:
02/26/2007

Additional Information

Authorized Official

Authorized Official Last Name:
CASIDA
Authorized Official First Name:
JON
Authorized Official Middle Name:
MICHAEL
Authorized Official Title or Position:
PROGRAM MANAGER
Authorized Official Telephone Number:
661-634-9737

Provider Taxonomy Codes

  • Taxonomy code: 324500000X , with the licence number:  150003EN AND 150003G , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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