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Individual

BENITA CASTILLO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
220 N LOCUST ST, VISALIA, CA 93291-4946
(559) 627-1385
(559) 636-2105
Mailing address
220 N LOCUST ST, VISALIA, CA 93291-4946
(559) 627-1385
(559) 636-2105

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
D77467520
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5478
MEDICAL
CA
Enumeration date
03/30/2015
Last updated
03/30/2015
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