Healthcare Provider Details

I. General information

NPI: 1083417042
Provider Name (Legal Business Name): AMY CASTILLO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2025
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2435 PYRAMID WAY STE B
SPARKS NV
89431-1865
US

IV. Provider business mailing address

344 W 2ND ST UNIT 507
RENO NV
89503-5380
US

V. Phone/Fax

Practice location:
  • Phone: 775-657-8309
  • Fax:
Mailing address:
  • Phone: 786-239-6539
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: