Kelly Breeding
Individual provider Active NPI Community Health Worker · Jackson, CA
NPI 1245048628 · NPPES record last updated Dec 18, 2024
Key facts
- NPI
- 1245048628
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Community Health Worker 172V00000X
- Practice address
- 217 Rex Ave
Jackson, CA 95642-2020 - Phone
- (209) 418-9800
- NPI assigned
- Dec 18, 2024
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Amador County Office of Education | Current |
Accepting new patients |
Locations
217 Rex Ave
Jackson, CA 95642
Phone (209) 283-3399
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | Yes |
Addresses
Primary practice location
217 Rex Ave
Jackson, CA 95642-2020
Mailing address
217 Rex Ave
Jackson, CA 95642-2020
Phone (206) 418-9800
Other providers in Jackson, CA
- Dennis Bourkov
- Thomas Alan Bowhay
- Brad Chew MD Inc
- Shawn K. Brady
- Belinda Lynnette Braggs
- Gregory Scott Brewer
- Douglas B Brock
- Gregory Paul Brotherton
- David Randall Bruce
- Alyssa Nicole Cabri
All providers in Jackson, CA · Community Health Worker in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 18, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.