Individual
DIANE SANTIAGO CASTILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
14809 STANTON AVE, LA MIRADA, CA 90638-4943
(714) 264-9804
Mailing address
PO BOX 202, LA MIRADA, CA 90637-0202
(714) 264-9804
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
11613
CA
Other
Enumeration date
01/09/2018
Last updated
01/09/2018
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