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General NPI Number Information
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NPI Number | 1235086976
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Entity Type | Organization
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Legal Business Name | GOOD ROOTS PSYCHOTHERAPY
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Dates
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Enumeration Date | 03/12/2026
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Last Update Date | 03/12/2026
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Provider Practice Location Address
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Address Line | 399 TAYLOR BLVD STE 210
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City | PLEASANT HILL
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State | CA
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Zip | 94523-2287
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Country | US
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Telephone | 925-685-9463
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Fax | 925-685-9682
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Provider Business Mailing Address
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Address Line | 399 TAYLOR BLVD STE 210
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City | PLEASANT HILL
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State | CA
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Zip | 94523-2287
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Country | US
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Telephone | 925-685-9463
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Fax | 925-685-9682
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Authorized Official
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Title or Position | OWNER
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Name | KOSTANDINA CASTRILLO
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Credential | LMFT
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Telephone | 925-864-1617
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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