Provider Demographics
NPI:1043846009
Name:CASILLAS, ERIN (OTR/L)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:CASILLAS
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31912 VIA SANTA ELENA
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:CA
Mailing Address - Zip Code:92596-8614
Mailing Address - Country:US
Mailing Address - Phone:719-439-2264
Mailing Address - Fax:
Practice Address - Street 1:30033 TECHNOLOGY DR STE 104
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92563-2640
Practice Address - Country:US
Practice Address - Phone:951-813-2820
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-20
Last Update Date:2020-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist