Individual
YESENIA CASTILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2668 INMAN AVE, STOCKTON, CA 95204-2649
(209) 518-9054
Mailing address
2668 INMAN AVE, STOCKTON, CA 95204-2649
(209) 518-9054
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
E1228152
CA
Other
Enumeration date
10/16/2020
Last updated
10/16/2020
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