Individual provider Active NPI

Lanetta Castillo, COTA/L

  • Occupational Therapy Assistant
  • Albuquerque, NM
National Provider Identifier
1861183550
Registry record updated May 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OTA3230 Issued in NM
Practice address
10320 Cottonwood Park NW Ste a
Albuquerque, NM 87114-7008
Phone
(505) 250-5204
NPI assigned
May 15, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X OTA3230 NM Primary

Addresses

Primary practice location

10320 Cottonwood Park NW Ste a
Albuquerque, NM 87114-7008

Mailing address

9219 Silver Mesa St NW
Albuquerque, NM 87114-6609
Phone (505) 453-1759

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

State licenses

LicenseStateTypeSpecialty
OTA3230NMMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1684108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684108800000",
    "number": "1861183550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9219 SILVER MESA ST NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871146609",
            "telephone_number": "505-453-1759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10320 COTTONWOOD PARK NW STE A",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871147008",
            "telephone_number": "505-250-5204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASTILLO",
        "first_name": "LANETTA",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-15",
        "last_updated": "2023-05-15",
        "certification_date": "2023-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "NM",
            "license": "OTA3230",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2023; 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.