Healthcare Provider Details
I. General information
NPI: 1174402408
Provider Name (Legal Business Name): VALERIE ITALIA CASTILLO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 08/29/2025
Last Update Date: 08/29/2025
Certification Date: 08/29/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1000 S FREMONT AVE BLDG A10S
ALHAMBRA CA
91803-8800
US
IV. Provider business mailing address
5818 LUDELL ST
BELL GARDENS CA
90201-4012
US
V. Phone/Fax
- Phone: 626-349-3838
- Fax: 855-838-9042
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 106S00000X |
| Taxonomy | Behavior Technician |
| License Number | |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: