Healthcare Provider Details

I. General information

NPI: 1962291484
Provider Name (Legal Business Name): NEW PURPOSE REENTRY PROGRAM, INC. (NPRP, INC.)
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2025
Last Update Date: 05/01/2025
Certification Date: 04/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3241 SHERIDAN WAY
STOCKTON CA
95219-3726
US

IV. Provider business mailing address

3241 SHERIDAN WAY
STOCKTON CA
95219-3726
US

V. Phone/Fax

Practice location:
  • Phone: 209-329-1014
  • Fax: 209-476-1834
Mailing address:
  • Phone: 209-329-1014
  • Fax: 209-476-1834

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code225C00000X
TaxonomyRehabilitation Counselor
License Number
License Number State

VIII. Authorized Official

Name: MRS. JEHNELL LIVINGSTON-TURNER
Title or Position: COO
Credential:
Phone: 209-329-1014