MEDICARE: CENTRAL VALLEY GENDER HEALTH & WELLNESS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	172V00000X	Community Health Worker

General Provider Information

NPI Number	:	1346119807
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTRAL VALLEY GENDER HEALTH & WELLNESS

Provider Business Mailing Address
First Line	:	PO BOX 5562
Second Line	:
City	:	STOCKTON
State	:	CA
Zip	:	95205-0562
Country	:	US
Telephone Number	:	209-475-8465
Fax Number	:

Provider Business Practice Location Address
First Line	:	1525 N EL DORADO ST STE 3
Second Line	:
City	:	STOCKTON
State	:	CA
Zip	:	95204-5932
Country	:	US
Telephone Number	:	209-475-8465
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MS. CYMONE A REYES
Credential	:
Telephone Number	:	209-271-7637

Provider Enumeration Date	:	11/03/2025
Last Update Date	:	11/03/2025

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