Healthcare Provider Details

I. General information

NPI: 1477331585
Provider Name (Legal Business Name): YULEINYS A CASTILLO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/19/2023
Last Update Date: 11/16/2023
Certification Date: 11/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 W FALLBROOK AVE STE 105
FRESNO CA
93711-6191
US

IV. Provider business mailing address

PO BOX 16063
FRESNO CA
93755-6063
US

V. Phone/Fax

Practice location:
  • Phone: 559-472-0501
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number10227
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: