Healthcare Provider Details

I. General information

NPI: 1659288447
Provider Name (Legal Business Name): GIOVANY CASTILLO-PALOMO
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4825 MORENO ST
MONTCLAIR CA
91763-1419
US

IV. Provider business mailing address

950 W D ST
ONTARIO CA
91762-3026
US

V. Phone/Fax

Practice location:
  • Phone: 909-445-1661
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: