Healthcare Provider Details

I. General information

NPI: 1770438541
Provider Name (Legal Business Name): YOLO HEALTHY AGING ALLIANCE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2026
Last Update Date: 02/26/2026
Certification Date: 02/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 A ST STE C
DAVIS CA
95616-3650
US

IV. Provider business mailing address

600 A ST STE C
DAVIS CA
95616-3650
US

V. Phone/Fax

Practice location:
  • Phone: 530-776-5006
  • Fax:
Mailing address:
  • Phone: 530-776-5006
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251X00000X
TaxonomySupports Brokerage Agency
License Number
License Number State

VIII. Authorized Official

Name: JULIE MARTIN
Title or Position: SENIOR ADVISOR
Credential:
Phone: 530-776-5006