Provider Demographics
NPI:1437326121
Name:MUNOZ, MABEL
Entity type:Individual
Prefix:MISS
First Name:MABEL
Middle Name:
Last Name:MUNOZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:KERN BEHAVIORAL HEALTH AND RECOVERY SERVICES
Mailing Address - Street 2:2525 NORTH CHESTER AVE.
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93308-1770
Mailing Address - Country:US
Mailing Address - Phone:661-868-1834
Mailing Address - Fax:
Practice Address - Street 1:KERN BEHAVIORAL HEALTH AND RECOVERY SERVICES
Practice Address - Street 2:2525 NORTH CHESTER AVE
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93308
Practice Address - Country:US
Practice Address - Phone:661-868-1888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-12
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103TF0200X, 171M00000X, 390200000X
CA94028392103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA7068Medicaid
CA7420Medicaid