Healthcare Provider Details

I. General information

NPI: 1659736049
Provider Name (Legal Business Name): JAN CASTILAN PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/29/2015
Last Update Date: 09/03/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2838 OSWELL ST
BAKERSFIELD CA
93306
US

IV. Provider business mailing address

3400 CALLOWAY DR STE 603
BAKERSFIELD CA
93312-2514
US

V. Phone/Fax

Practice location:
  • Phone: 661-377-1700
  • Fax: 661-616-9199
Mailing address:
  • Phone: 661-377-1700
  • Fax: 661-616-9199

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT43575
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: