Active NPI
Jose Castillo
- Mental Health Counselor
- Modesto, CA
National Provider Identifier
1245956960
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 12428
- Practice address
- 4700 Enterprise Way
Modesto, CA 95356 - Phone
- (209) 550-6013
- NPI assigned
- Oct 14, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 12428 | CA | Primary |
Addresses
Primary practice location
4700 Enterprise Way
Modesto, CA 95356
Mailing address
Kaiser Permanente Behavioral Health Department
4700 Enterprise Way
Modesto, CA 95356
Phone (185) 526-8409
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12428 | CA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1665705600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1665705600000",
"number": "1245956960",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "KAISER PERMANENTE BEHAVIORAL HEALTH DEPARTMENT",
"address_2": "4700 ENTERPRISE WAY",
"city": "MODESTO",
"state": "CA",
"postal_code": "95356",
"telephone_number": "185-526-8409"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4700 ENTERPRISE WAY",
"city": "MODESTO",
"state": "CA",
"postal_code": "95356",
"telephone_number": "209-550-6013"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CASTILLO",
"first_name": "JOSE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-10-14",
"last_updated": "2022-10-14",
"certification_date": "2022-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "12428",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Modesto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.