Healthcare Provider Details

I. General information

NPI: 1093636938
Provider Name (Legal Business Name): THE HEALING PATH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2026
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1540 E INDUSTRIAL ST APT 265
LOS ANGELES CA
90021-1297
US

IV. Provider business mailing address

2108 N ST STE N
SACRAMENTO CA
95816-5712
US

V. Phone/Fax

Practice location:
  • Phone: 916-538-9903
  • Fax:
Mailing address:
  • Phone: 916-538-9903
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: KINESHA L KELLY
Title or Position: FOUNDER & CEO
Credential: M.A.
Phone: 916-538-9903