Individual
CLARISSA A CASTILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
4004 BEYER BLVD, SAN YSIDRO, CA 92173
(619) 662-4100
(619) 428-7952
Mailing address
1275 30TH ST, SAN DIEGO, CA 92154-3476
(619) 662-4100
(619) 428-7952
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
18154
CA
364SF0001X
Family Health Clinical Nurse Specialist
PA18154
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
FHC18880F
MEDI-CAL
—
Enumeration date
08/14/2006
Last updated
08/29/2018
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