Individual provider Active NPI

Maria Virginia Castelli, NURSE PRACTITIONER

  • Psychiatric/Mental Health Nurse Practitioner
  • Campbell, CA
National Provider Identifier
1194766113
Registry record updated Apr 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
NP12655 Issued in CA
Practice address
2542 S Bascom Ave
Ste 110
Campbell, CA 95008-5541
Phone
(408) 559-3403
Fax
(408) 559-3158
NPI assigned
Jun 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN291997 CA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NP12655 CA Primary

Addresses

Primary practice location

2542 S Bascom Ave
Ste 110
Campbell, CA 95008-5541

Mailing address

2542 S Bascom Ave
Ste 110
Campbell, CA 95008-5541
Phone (408) 559-3403

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12655CAMDOptometrist
RN291997CAMDRegistered Nurse
NP12655CAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
LGTC Inc PastSince Feb 1, 2024 Accepting new patients
Psychiatric Centers at San Diego, Inc. Med GRP Past Accepting new patients
LGTC Group Psychiatric/Mental Health PastSince May 20, 2025 Accepting new patients
Los Gatos Therapy Center PastSince Apr 17, 2022 Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 4

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461024000000",
    "number": "1194766113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2542 S BASCOM AVE",
            "address_2": "STE 110",
            "city": "CAMPBELL",
            "state": "CA",
            "postal_code": "950085541",
            "telephone_number": "408-559-3403",
            "fax_number": "408-559-3158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2542 S BASCOM AVE",
            "address_2": "STE 110",
            "city": "CAMPBELL",
            "state": "CA",
            "postal_code": "950085541",
            "telephone_number": "408-559-3403",
            "fax_number": "408-559-3158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASTELLI",
        "first_name": "MARIA",
        "middle_name": "VIRGINIA",
        "name_prefix": "Dr.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-09",
        "last_updated": "2016-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "RN291997",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "NP12655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Campbell, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.