Individual provider Active NPI

Maria Amanda Castillo Marquez, RN

  • Psychiatric/Mental Health Registered Nurse
  • Granada Hills, CA
National Provider Identifier
1700961661
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X
License
402769 Issued in CA
Practice address
10605 Balboa Blvd
100
Granada Hills, CA 91344-6342
Phone
(818) 832-2410
Fax
(818) 832-2567
NPI assigned
Oct 26, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered Nurse 163WP0808X 402769 CA Primary

Addresses

Primary practice location

10605 Balboa Blvd
100
Granada Hills, CA 91344-6342

Mailing address

10605 Balboa Blvd
100
Granada Hills, CA 91344-6342
Phone (818) 832-2410

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)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
402769CAMDPsychiatric/Mental Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700961661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10605 BALBOA BLVD",
            "address_2": "100",
            "city": "GRANADA HILLS",
            "state": "CA",
            "postal_code": "913446342",
            "telephone_number": "818-832-2410",
            "fax_number": "818-832-2567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10605 BALBOA BLVD",
            "address_2": "100",
            "city": "GRANADA HILLS",
            "state": "CA",
            "postal_code": "913446342",
            "telephone_number": "818-832-2410",
            "fax_number": "818-832-2567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASTILLO MARQUEZ",
        "first_name": "MARIA",
        "middle_name": "AMANDA",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "CA",
            "license": "402769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Granada Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.