Healthcare Provider Details

I. General information

NPI: 1548126287
Provider Name (Legal Business Name): KARLA MARIA CHINCHILLA CASTRO ASW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KARLA CHINCHILLA ASW

II. Dates (important events)

Enumeration Date: 12/26/2025
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 E MAIN ST STE 203
TUSTIN CA
92780-4414
US

IV. Provider business mailing address

5000 BIRCH ST STE 3000
NEWPORT BEACH CA
92660-2140
US

V. Phone/Fax

Practice location:
  • Phone: 877-421-1711
  • Fax:
Mailing address:
  • Phone: 877-421-1711
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number132151
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: