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Rashard O Stallworth Sr.

Counselor, Mental Health in Stockton, CA. Individual provider (NPI-1).

NPI number1417124231
StatusActive
Last updated in NPPESFeb 19, 2021

Details

NPI
1417124231
Entity type
Individual (NPI-1)
Name
Mr. Rashard O Stallworth Sr.
Sex
Male
Sole proprietor
Yes
Enumeration date
May 12, 2008
Certification date
Feb 19, 2021
Last updated
Feb 19, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
101YM0800X Counselor, Mental Health––Yes

Practice location

1212 N California St
Stockton, CA 95202-1552

Phone 209-468-0102

Mailing address

1149 N. California Street
Stockton, CA 95202

Phone 209-468-2337

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