Individual
JAMIE IRENE CONKLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
58923 BUSINESS CENTER DR, YUCCA VALLEY, CA 92284-7311
(760) 365-7206
Mailing address
58923 BUSINESS CENTER DR, YUCCA VALLEY, CA 92284-7311
(760) 881-8576
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
172V00000X
Community Health Worker
—
—
372600000X
Adult Companion
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1437555117
—
CA
Enumeration date
05/21/2018
Last updated
04/10/2025
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