Healthcare Provider Details

I. General information

NPI: 1023201019
Provider Name (Legal Business Name): ANA ALICIA CASTLE MA, LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ANITA CASTLE

II. Dates (important events)

Enumeration Date: 08/22/2007
Last Update Date: 05/31/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 LONG BEACH BLVD STE 210
LONG BEACH CA
90807-2617
US

IV. Provider business mailing address

4000 LONG BEACH BLVD STE 210
LONG BEACH CA
90807-2617
US

V. Phone/Fax

Practice location:
  • Phone: 805-252-2509
  • Fax:
Mailing address:
  • Phone: 805-252-2509
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: