Khyra Conerly
Community Health Worker in Stockton, CA. Individual provider (NPI-1).
NPI number1902525751
StatusActive
Last updated in NPPESJan 25, 2024
Details
- NPI
- 1902525751
- Entity type
- Individual (NPI-1)
- Name
- Khyra Conerly
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 24, 2022
- Certification date
- Jan 25, 2024
- Last updated
- Jan 25, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 172V00000X | Community Health Worker | – | – | Yes |
| 101Y00000X | Counselor | – | – | |
| 101YM0800X | Counselor, Mental Health | – | – |
Practice location
2495 W March Ln Ste 125Stockton, CA 95207-8224
Phone 209-465-1080
Mailing address
2495 W March Ln Ste 125Stockton, CA 95207-8224
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All 202 Community Health Worker providers in Stockton · All 11,041 providers in Stockton
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