Healthcare Provider Details

I. General information

NPI: 1427975630
Provider Name (Legal Business Name): MARIA CASTILLO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/30/2026
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4880 MARKET ST
VENTURA CA
93003-7783
US

IV. Provider business mailing address

948 RAVENSCOURT AVE APT 1
SAN JOSE CA
95128-3820
US

V. Phone/Fax

Practice location:
  • Phone: 669-242-5090
  • Fax:
Mailing address:
  • Phone: 408-401-0271
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: