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NPI Code Detail

MEDICARE: JIMELA KRYSTAL ABDELKADIR

MEDICARE: JIMELA KRYSTAL ABDELKADIR
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician
2172V00000XCommunity Health Worker
3372600000XAdult Companion
4175T00000XPeer SpecialistCA

General Provider Information

NPI Number : 1720577091
Entity Type Code : Individual
Provider Name (Legal Business Name) : JIMELA KRYSTAL ABDELKADIR
Provider Business Mailing Address
First Line : 3801 DUCKHORN DR APT 635
Second Line :
City : SACRAMENTO
State : CA
Zip : 95834-1079
Country : US
Telephone Number : 553-216-8311
Fax Number :
Provider Business Practice Location Address
First Line : 1050 FULTON AVE STE 35
Second Line :
City : SACRAMENTO
State : CA
Zip : 95825-4272
Country : US
Telephone Number : 916-974-2599
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/02/2018
Last Update Date : 12/09/2025

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Directions to “ JIMELA KRYSTAL ABDELKADIR ” Practice Location

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