Provider Demographics
NPI:1417761586
Name:DEL CASTILLO, JORDAN (PA-C)
Entity type:Individual
Prefix:MR
First Name:JORDAN
Middle Name:
Last Name:DEL CASTILLO
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1487 LANDESS AVE
Mailing Address - Street 2:
Mailing Address - City:MILPITAS
Mailing Address - State:CA
Mailing Address - Zip Code:95035-6953
Mailing Address - Country:US
Mailing Address - Phone:408-909-0015
Mailing Address - Fax:669-500-7491
Practice Address - Street 1:1487 LANDESS AVE
Practice Address - Street 2:
Practice Address - City:MILPITAS
Practice Address - State:CA
Practice Address - Zip Code:95035-6953
Practice Address - Country:US
Practice Address - Phone:408-909-0015
Practice Address - Fax:669-500-7491
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-06
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Single Specialty