Provider Demographics
NPI:1013566975
Name:CASTILLO, ANALISE (MSW)
Entity Type:Individual
Prefix:
First Name:ANALISE
Middle Name:
Last Name:CASTILLO
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6001 CLARA ST
Mailing Address - Street 2:
Mailing Address - City:BELL GARDENS
Mailing Address - State:CA
Mailing Address - Zip Code:90201-4723
Mailing Address - Country:US
Mailing Address - Phone:562-806-5000
Mailing Address - Fax:
Practice Address - Street 1:6001 CLARA ST
Practice Address - Street 2:
Practice Address - City:BELL GARDENS
Practice Address - State:CA
Practice Address - Zip Code:90201-4723
Practice Address - Country:US
Practice Address - Phone:562-806-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-04
Last Update Date:2020-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA96212101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA953893470OtherLOS ANGELES COUNTY DEPARTMENT OF MENTAL HEALTH