Healthcare Provider Details
I. General information
NPI: 1982913059
Provider Name (Legal Business Name): ESTHER ANN CASTILLO L.C.S.W.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 10/06/2010
Last Update Date: 10/06/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
418 ALHAMBRA BLVD
SACRAMENTO CA
95816-3321
US
IV. Provider business mailing address
418 ALHAMBRA BLVD
SACRAMENTO CA
95816-3321
US
V. Phone/Fax
- Phone: 916-492-2141
- Fax:
- Phone: 916-492-2141
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | LCS8598 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: