Healthcare Provider Details

I. General information

NPI: 1811802853
Provider Name (Legal Business Name): GENESIS CASTILLO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/15/2026
Last Update Date: 08/15/2026
Certification Date: 08/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23450 NEWHALL AVE
SANTA CLARITA CA
91321-3147
US

IV. Provider business mailing address

23450 NEWHALL AVE SPC 147
NEWHALL CA
91321-3100
US

V. Phone/Fax

Practice location:
  • Phone: 818-405-2918
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberU0268999
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: