Angelica Castro, LMFT – Marriage & Family Therapist

Key facts

NPI: 1023328382
Entity type: Individual (NPI type 1)
Primary specialty: Marriage & Family Therapist 106H00000X
License: 111559 (CA)
Practice address: 245 N Murray St
Banning, CA 92220-5528
Phone: (951) 663-8366
Fax: (951) 755-8915
NPI assigned: Oct 20, 2010
Sex: Female
Sole proprietor: Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Group Home Support Services Mental Health Clinic/Center (Including Community Mental Health Center) · Banning, CA · NPI 1578893699

NPD (past)

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
111559	CA	MD	Public Health Dentist
RS5986	CA	MD	Health Educator

Practice roles

Organization	Specialty	Status	New patients
Group Home Support Services		Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Health Educator	174H00000X	RS5986	CA
Marriage & Family Therapist	106H00000X	111559	CA	Yes

Addresses

Primary practice location

245 N Murray St
Banning, CA 92220-5528

Mailing address

9169 Middlefield Dr
Riverside, CA 92508-6272
Phone (951) 902-7077

Electronic endpoints

Type	Endpoint	Use	Affiliation
SOAP URL	https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq	Health Information Exchange (HIE)	Southern California Permanente Medical Group

Other providers in Banning, CA

Benjamin Patrick Carrillo-Sanchez, MFTI
Andrew Scott Carson, LVN
Joshua Bryan Castillo
Mayella Castillo
Adam Abel Castro, LPCC 9442
Diane M Castro
Brittney Ann Centeno-Reinke, MS, CCC-SLP
Cep America - California
Cep America - Neurology PC
Sarah Chan, PA-C

All providers in Banning, CA · Marriage & Family Therapist in California

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 24, 2021. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.