Healthcare Provider Details

I. General information

NPI: 1700829785
Provider Name (Legal Business Name): PEDRO GARRIDO-CASTILLO PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/14/2006
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1330 BEACON ST STE 255
BROOKLINE MA
02446-3200
US

IV. Provider business mailing address

1330 BEACON ST STE 255
BROOKLINE MA
02446-3200
US

V. Phone/Fax

Practice location:
  • Phone: 617-285-7779
  • Fax: 617-889-8509
Mailing address:
  • Phone: 617-285-7779
  • Fax: 617-889-8509

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number3864
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: