Individual
MICHELLE CASTRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTD, OTR/L
Contact information
Practice address
1499 S TIPPECANOE AVE # A, SAN BERNARDINO, CA 92408-2920
(909) 799-3777
Mailing address
1499 S TIPPECANOE AVE # A, SAN BERNARDINO, CA 92408-2920
(909) 799-3777
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
13827
CA
225XP0200X
Pediatric Occupational Therapist
Primary
13827
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1194136572
INDIVIDUAL
CA
Enumeration date
05/19/2014
Last updated
01/04/2023
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