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General NPI Number Information
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NPI Number | 1396479366
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Entity Type | Individual
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Provider Name | ANNETTE IRAZEMA CASTILLO
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Gender | Female
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Dates
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Enumeration Date | 07/14/2022
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Last Update Date | 11/22/2024
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Provider Practice Location Address
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Address Line | 200 W SANTA ANA BLVD STE 100
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City | SANTA ANA
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State | CA
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Zip | 92701-4134
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Country | US
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Telephone | 714-480-6660
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Fax |
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Provider Business Mailing Address
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Address Line | 1940 E DEERE AVE STE 100
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City | SANTA ANA
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State | CA
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Zip | 92705-5718
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Country | US
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Telephone | 714-543-4333
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 127683
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License Number State | CA
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