MEDICARE: MELISSA JANICE CASTILLO

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number State
1	373H00000X	Day Training/Habilitation Specialist	CA
2	106S00000X	Behavior Technician	CA
3	172V00000X	Community Health Worker	CA
4	171M00000X	Case Manager/Care Coordinator	CA

General Provider Information

NPI Number	:	1841830668
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA JANICE CASTILLO

Provider Business Mailing Address
First Line	:	1902 MARENGO ST STE 200C
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90033-1382
Country	:	US
Telephone Number	:	323-276-6470
Fax Number	:

Provider Business Practice Location Address
First Line	:	1902 MARENGO ST # 109110
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90033-1312
Country	:	US
Telephone Number	:	323-276-6470
Fax Number	:

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

Provider Enumeration Date	:	01/09/2020
Last Update Date	:	09/22/2025

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Directions to “ MELISSA JANICE CASTILLO ” Practice Location

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