Provider Demographics
NPI:1104339761
Name:KERN COMMUNITY COLLEGE DISTRICT
Entity type:Organization
Organization Name:KERN COMMUNITY COLLEGE DISTRICT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:INTERIM CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:A
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-336-5124
Mailing Address - Street 1:1801 PANORAMA DRIVE
Mailing Address - Street 2:STUDENT HEALTH AND WELLNESS CENTER
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93305-1219
Mailing Address - Country:US
Mailing Address - Phone:661-395-4336
Mailing Address - Fax:661-395-4235
Practice Address - Street 1:1801 PANORAMA DR
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93305-1219
Practice Address - Country:US
Practice Address - Phone:661-395-4336
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-06
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
No261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health