Amani Ali

Individual provider Active NPI Community Health Worker · Stockton, CA

NPI 1760040232 · NPPES record last updated Jan 12, 2024

Key facts

NPI
1760040232
Entity type
Individual (NPI type 1)
Primary specialty
Community Health Worker 172V00000X
Practice address
4545 Georgetown PL Ste D
Stockton, CA 95207-6229
Phone
(209) 269-5587
NPI assigned
May 30, 2019
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
Mental Health Counselor 101YM0800X
Behavior Technician 106S00000X CA
Community Health Worker 172V00000X Yes

Addresses

Primary practice location

4545 Georgetown PL Ste D
Stockton, CA 95207-6229

Mailing address

4545 Georgetown PL Ste D
Stockton, CA 95207-6229
Phone (209) 269-5587

Other providers in Stockton, CA

All providers in Stockton, CA · Community Health Worker in California

Sources for this page

Verify at the official NPI Registry.