Individual
ANTONIO CASILLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA
Contact information
Practice address
2579 SAN PABLO AVE, OAKLAND, CA 94612-1159
(510) 446-7100
Mailing address
2579 SAN PABLO AVE, OAKLAND, CA 94612-1159
(510) 446-7100
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
APCC6119
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
APCC6119
ASSOCIATE PROFESSIONAL CLINICAL COUNSELOR
CA
Enumeration date
01/10/2018
Last updated
03/13/2019
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