MEDICARE: TIFFANIE CASTILLO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	86385	TX

General Provider Information

NPI Number	:	1043904238
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIFFANIE CASTILLO

Provider Business Mailing Address
First Line	:	19780 S US HIGHWAY 281
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78221-9761
Country	:	US
Telephone Number	:	210-262-0600
Fax Number	:

Provider Business Practice Location Address
First Line	:	19780 S US HIGHWAY 281
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78221-9761
Country	:	US
Telephone Number	:	210-262-0600
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/08/2023
Last Update Date	:	06/08/2023

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Directions to “ TIFFANIE CASTILLO ” Practice Location

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