Healthcare Provider Details

I. General information

NPI: 1477677581
Provider Name (Legal Business Name): ALICE CASTILLO CADC II
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALICE CASTILLO CADC II

II. Dates (important events)

Enumeration Date: 03/16/2007
Last Update Date: 02/17/2021
Certification Date: 02/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 L ST
BAKERSFIELD CA
93301-4522
US

IV. Provider business mailing address

PO BOX 1000
BAKERSFIELD CA
93302-1000
US

V. Phone/Fax

Practice location:
  • Phone: 661-868-7151
  • Fax: 661-868-0840
Mailing address:
  • Phone: 661-868-6601
  • Fax: 661-868-6611

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberA03750315
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License NumberA03750315
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: