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NPI Code Detail

MEDICARE: CELINE THERESE CASTILLO BA

MEDICARE: CELINE THERESE CASTILLO BA
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
1103K00000XBehavior Analyst1-20-44167CA

General Provider Information

NPI Number : 1528569605
Entity Type Code : Individual
Provider Name (Legal Business Name) : CELINE THERESE CASTILLO BA
Provider Business Mailing Address
First Line : 21600 OXNARD ST STE 1800
Second Line :
City : WOODLAND HILLS
State : CA
Zip : 91367-7807
Country : US
Telephone Number : 818-345-2345
Fax Number :
Provider Business Practice Location Address
First Line : 2865 SUNRISE BLVD STE 112
Second Line :
City : RANCHO CORDOVA
State : CA
Zip : 95742-6108
Country : US
Telephone Number : 805-778-8735
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/23/2018
Last Update Date : 05/22/2023

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