Healthcare Provider Details

I. General information

NPI: 1346779121
Provider Name (Legal Business Name): YOSELIN MARIA MONTES CASTILLO-YIP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/06/2017
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 N JUNIPER ST
NORTH LIBERTY IA
52317-7821
US

IV. Provider business mailing address

315 N JUNIPER ST
NORTH LIBERTY IA
52317-7821
US

V. Phone/Fax

Practice location:
  • Phone: 323-929-2020
  • Fax:
Mailing address:
  • Phone: 323-929-2020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number109286
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number124368
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number140538
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: