Kelsey Marie Mixon

Individual provider Active NPI Community Health Worker · Lake Isabella, CA

NPI 1144095563 · NPPES record last updated Dec 8, 2023

Key facts

NPI
1144095563
Entity type
Individual (NPI type 1)
Primary specialty
Community Health Worker 172V00000X
Practice address
2731 Nugget Ave
Lake Isabella, CA 93240-9456
Phone
(760) 379-3412
NPI assigned
Nov 15, 2023
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X
Community Health Worker 172V00000X Yes

Addresses

Primary practice location

2731 Nugget Ave
Lake Isabella, CA 93240-9456

Mailing address

2731 Nugget Ave
Lake Isabella, CA 93240-9456

Other providers in Lake Isabella, CA

All providers in Lake Isabella, CA · Community Health Worker in California

Sources for this page

Verify at the official NPI Registry.