Healthcare Provider Details

I. General information

NPI: 1346199304
Provider Name (Legal Business Name): KAYJA LYNNE ALFORD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2026
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2903 WHITTIER CT
STOCKTON CA
95207-2317
US

IV. Provider business mailing address

2903 WHITTIER CT
STOCKTON CA
95207-2317
US

V. Phone/Fax

Practice location:
  • Phone: 209-468-9631
  • Fax:
Mailing address:
  • Phone: 209-468-9631
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: