Castro, Jennifer Nichole

Castro, Jennifer Nichole is an sole proprietor health care provider with primary practice located at 1915 D St , Antioch CA 94509-2571. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Behavior Technician, Other Service Providers / Community Health Worker. Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) is her primary health care specialty. Castro, Jennifer Nichole can be contacted via phone (925) 754-3673.

Contact Information

Primary practice address
1915 D St Antioch CA 94509-2571
Phone: (925) 754-3673
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X
Behavioral Health & Social Service Providers / Behavior Technician 106S00000X California
Other Service Providers / Community Health Worker 172V00000X California
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X California

Profile Details

NPI number 1235891177
LBN Legal business name Castro, Jennifer Nichole
Credentials CADC-I
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 7th, 2021
Last updated Nov 8th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1235891177 NPPES
California MEDICAID 1689863516

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