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NPI Code Detail

MEDICARE: TIFFANY ALEXIS CASTILLO

MEDICARE: TIFFANY ALEXIS CASTILLO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program
22084P0800XPsychiatry Physician158480CA

General Provider Information

NPI Number : 1114459252
Entity Type Code : Individual
Provider Name (Legal Business Name) : TIFFANY ALEXIS CASTILLO
Provider Business Mailing Address
First Line : 488 E VALLEY PKWY STE 311
Second Line :
City : ESCONDIDO
State : CA
Zip : 92025-3374
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 488 E VALLEY PKWY STE 311
Second Line :
City : ESCONDIDO
State : CA
Zip : 92025-3374
Country : US
Telephone Number : 833-867-4642
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/29/2017
Last Update Date : 03/05/2026

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Directions to “ TIFFANY ALEXIS CASTILLO ” Practice Location

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