Diane Theresa Castillo, PH.D.
Individual provider Active NPI Clinical Psychologist · Albuquerque, NM
NPI 1306959283 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1306959283
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 0767 (NM)
- Practice address
- 1501 San Pedro Dr SE
Albuquerque, NM 87108-5153 - Phone
- (505) 265-1711
- Fax
- (505) 256-6413
- NPI assigned
- Aug 16, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0767 | NM | MD | Clinical Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 0767 | NM | Yes |
Addresses
Primary practice location
1501 San Pedro Dr SE
Albuquerque, NM 87108-5153
Mailing address
8020 Camino de Aguila NW
Albuquerque, NM 87120-5902
Phone (505) 836-5752
Other providers in Albuquerque, NM
- Carolyn Marie Castillo
- Christopher Castillo
- Damian H Castillo
- Daniel Castillo
- David Anthony Castillo
- Elizabeth Diane Castillo
- Estefany Castillo
- Gabriel Ray Castillo
- Javier Antonio Castillo
- Jazmin Mariah Castillo
All providers in Albuquerque, NM · Clinical Psychologist in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. 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.