Individual
BLANCA OLIVIA CASTELO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4189 THE HILL RD, BONITA, CA 91902-2343
(619) 479-4943
Mailing address
7024 TENBURY CT, SAN DIEGO, CA 92139-2948
(619) 808-2208
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
B6863287
DRIVER LICENSE
CA
Enumeration date
03/03/2020
Last updated
03/03/2020
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