Healthcare Provider Details

I. General information

NPI: 1093642225
Provider Name (Legal Business Name): CENTRAL VALLEY GENDER HEALTH & WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1525 N EL DORADO ST STE 3
STOCKTON CA
95204-5932
US

IV. Provider business mailing address

PO BOX 5562
STOCKTON CA
95205-0562
US

V. Phone/Fax

Practice location:
  • Phone: 350-228-8870
  • Fax:
Mailing address:
  • Phone: 350-228-8870
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. CYMONE A REYES
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 350-228-8870