Individual
DOMINIC MAURICE CASACA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RADT
Contact information
Practice address
1212 CALIFORNIA ST., STOCKTON, CA 95204
(209) 953-5465
Mailing address
616 PERFIDIA AVE, MODESTO, CA 95351-4135
(209) 781-5279
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
172V00000X
Community Health Worker
—
—
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Enumeration date
08/24/2018
Last updated
06/18/2025
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