Individual
KENDRA LANAI CASTILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
620 N AURORA ST, STOCKTON, CA 95202-2343
(209) 468-9370
Mailing address
620 N AURORA ST, STOCKTON, CA 95202-2343
(209) 468-9370
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
172V00000X
Community Health Worker
—
—
175T00000X
Peer Specialist
Primary
MPSS-QHSVNL
CA
373H00000X
Day Training/Habilitation Specialist
—
—
Other
Enumeration date
06/30/2023
Last updated
04/06/2026
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