Provider Demographics
NPI:1992572135
Name:MOBLEY, BYKEMA
Entity type:Individual
Prefix:
First Name:BYKEMA
Middle Name:
Last Name:MOBLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4142 E MORADA LN APT 4201
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95212-1687
Mailing Address - Country:US
Mailing Address - Phone:510-378-0780
Mailing Address - Fax:
Practice Address - Street 1:4142 E MORADA LN APT 4201
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95212-1687
Practice Address - Country:US
Practice Address - Phone:510-378-0780
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-07
Last Update Date:2024-12-17
Deactivation Date:2024-01-25
Deactivation Code:
Reactivation Date:2024-12-17
Provider Licenses
StateLicense IDTaxonomies
CA374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula