Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kassandra Alexis Mickelson

Individual provider Behavior Technician · NPI 1265175962

Kassandra Alexis Mickelson is a Behavior Technician in Stockton, California. Licensed in California. Registered with an NPI since 2022.

Licensed in
CA
In the registry since
2022

Practice location Address checks out

1811 Grand Canal Blvd Ste 2
Stockton, CA 95207-8107
Phone: (530) 721-9074
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Behavior Technician (primary) Taxonomy 106S00000X (CA)

Record details

NPI number1265175962
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedApril 19, 2022
Last updated in NPPESApril 19, 2022
Certification dateApril 19, 2022

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