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General NPI Number Information
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NPI Number | 1629844394
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Entity Type | Individual
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Provider Name | KEYSHAWN CASTRO BCBA
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Gender | Male
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Dates
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Enumeration Date | 12/04/2023
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Last Update Date | 12/04/2023
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Provider Practice Location Address
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Address Line | 227 N LOOP 1604 E STE 150
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City | SAN ANTONIO
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State | TX
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Zip | 78232-1450
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Country | US
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Telephone | 210-749-0400
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Fax |
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Provider Business Mailing Address
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Address Line | 18726 S WESTERN AVE
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City | GARDENA
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State | CA
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Zip | 90248-3813
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Country | US
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Telephone | 310-856-0800
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Fax | 855-568-2494
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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