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General NPI Number Information
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NPI Number | 1689035586
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Entity Type | Organization
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Legal Business Name | CASTORENA THERAPEUTIC SERVICES, INC
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Dates
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Enumeration Date | 03/19/2016
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Last Update Date | 03/19/2016
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Provider Practice Location Address
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Address Line | 4370 TUJUNGA AVE SUITE 150
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City | STUDIO CITY
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State | CA
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Zip | 91604-2776
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Country | US
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Telephone | 818-514-5655
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 443
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City | BURBANK
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State | CA
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Zip | 91503-0443
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | CHRISTINA CASTORENA
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Credential | LMFT
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Telephone | 818-514-5655
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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 | LMFT77161
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License Number State | CA
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