Healthcare Provider Details

I. General information

NPI: 1043140783
Provider Name (Legal Business Name): CENTRAL VALLEY NE MEDICAL TRANSPORTATION, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2026
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1131 RIVER CREST CT
STOCKTON CA
95206-6259
US

IV. Provider business mailing address

1131 RIVER CREST CT
STOCKTON CA
95206-6259
US

V. Phone/Fax

Practice location:
  • Phone: 510-331-4604
  • Fax:
Mailing address:
  • Phone: 510-331-4604
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: MR. JAMES LAMARR GREEN
Title or Position: OWNER
Credential:
Phone: 510-331-4604