Crystal Pauline Castillo

Individual provider Active NPI Clinical Social Worker · Grand Terrace, CA

NPI 1841503117 · NPPES record last updated Sep 10, 2020

Key facts

NPI
1841503117
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
66553 (CA)
Practice address
12320 Whistler St
Grand Terrace, CA 92313-5550
Phone
(909) 800-4796
NPI assigned
Jul 15, 2010
Sex
Female
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
School Social Worker 1041S0200X
Clinical Social Worker 1041C0700X 66553 CA Yes

Addresses

Primary practice location

12320 Whistler St
Grand Terrace, CA 92313-5550

Mailing address

12320 Whistler St
Grand Terrace, CA 92313-5550
Phone (909) 800-4796

Other providers in Grand Terrace, CA

All providers in Grand Terrace, CA · Clinical Social Worker in California

Sources for this page

Verify at the official NPI Registry.