Healthcare Provider Details

I. General information

NPI: 1023707999
Provider Name (Legal Business Name): READY TO WORK
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2023
Last Update Date: 05/04/2023
Certification Date: 05/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 N SUTTER ST STE 203
STOCKTON CA
95202-2911
US

IV. Provider business mailing address

119 E WEBER AVE
STOCKTON CA
95202-2704
US

V. Phone/Fax

Practice location:
  • Phone: 209-423-5082
  • Fax:
Mailing address:
  • Phone: 209-423-5082
  • 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 Code174200000X
TaxonomyMeals Provider
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code177F00000X
TaxonomyLodging Provider
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: KAYLAA ELIZABETH MARTIN
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 209-423-5082