Most Relevant Information
Provider Data
| NPI Number: | 1003641119 |
| Provider Name: | KEVIN DEVILLE CLEMMONS |
| Entity Type: | Individual |
| Taxonomy Code: | 172V00000X |
| Specialty: | Community Health Worker |
| License Number: |
Most Important Dates
| Enumeration Date: | 09/06/2024 |
| Last Updated: | 09/06/2024 |
Provider Practice Location
NEW DIRECTION-650 HOWE AVE BLDG. 400-B
SACRAMENTO
CA
95825
Practice Location Phone/Fax
| Phone: | 9164410123 |
| Fax: | 9164416893 |
Provider Mailing Location
NEW DIRECTION- 650 HOWE AVE. BLDG. 400-B
SACRAMENTO
CA
95825
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |