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NPI Code Detail

MEDICARE: BRENDA DEL CASTILLO

MEDICARE: BRENDA DEL 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
1101YA0400XAddiction (Substance Use Disorder) CounselorC4721214CA
2101YP2500XProfessional CounselorC4721214CA
3171W00000XContractor

General Provider Information

NPI Number : 1831605948
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRENDA DEL CASTILLO
Provider Business Mailing Address
First Line : 1144 W 65TH PL
Second Line :
City : LOS ANGELES
State : CA
Zip : 90044-3616
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2644 30TH ST STE 100
Second Line :
City : SANTA MONICA
State : CA
Zip : 90405-3051
Country : US
Telephone Number : 310-314-6200
Fax Number : 310-450-2024
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/27/2017
Last Update Date : 11/14/2022

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Directions to “ BRENDA DEL CASTILLO ” Practice Location

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