Candelario Jack Castillo III, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

79936 Issued in CA

Practice address

1420 Willow Pass Rd
Suite 200
Concord, CA 94520-5823

Phone

(925) 521-5159

Fax

(925) 646-5622

NPI assigned

Mar 17, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1458172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508284800000",
    "number": "1730540782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 WILLOW PASS RD",
            "address_2": "SUITE 200",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945205823",
            "telephone_number": "925-521-5159",
            "fax_number": "925-646-5622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 WILLOW PASS RD",
            "address_2": "SUITE 200",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945205823",
            "telephone_number": "925-521-5159",
            "fax_number": "925-646-5622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASTILLO",
        "first_name": "CANDELARIO",
        "middle_name": "JACK",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-17",
        "last_updated": "2017-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "79936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine Castilla
• Margie Abadines Castillano
• Zoe Castillanos
• Deisy Yadira Castillo Avendano
• Lorena Castillo Chiesa
• Christopher Castillo
• Cindy Castillo
• Jessica Castillo
• Kevin Wilfredo Castillo
• Mary Grace Villalon Castillo, PHYSICAL THERAPIST

• Clinical Social Worker in Concord, CA
• Providers in Concord, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2017; 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.