Healthcare Provider Details

I. General information

NPI: 1093626624
Provider Name (Legal Business Name): CORE CHW
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22810 TOM CT
TEHACHAPI CA
93561-8279
US

IV. Provider business mailing address

22810 TOM CT
TEHACHAPI CA
93561-8279
US

V. Phone/Fax

Practice location:
  • Phone: 661-858-6989
  • Fax:
Mailing address:
  • Phone: 661-858-6989
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: ANABEL GRIFFIN
Title or Position: CEO
Credential: CHW
Phone: 661-858-6989