Individual
EZEQUIEL ALCANTAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1414 N CALIFORNIA ST, STOCKTON, CA 95202-1515
(209) 468-2385
Mailing address
1414 N CALIFORNIA ST, STOCKTON, CA 95202-1515
(209) 468-2385
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
172V00000X
Community Health Worker
—
—
175T00000X
Peer Specialist
Primary
—
—
373H00000X
Day Training/Habilitation Specialist
—
—
Other
Enumeration date
04/18/2017
Last updated
06/05/2025
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