Provider Demographics
NPI:1073907424
Name:CASTALIA, ARI-ASHA (MFT)
Entity Type:Individual
Prefix:
First Name:ARI-ASHA
Middle Name:
Last Name:CASTALIA
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 W 25TH AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94403-2297
Mailing Address - Country:US
Mailing Address - Phone:650-762-8602
Mailing Address - Fax:
Practice Address - Street 1:112 W 25TH AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94403-2297
Practice Address - Country:US
Practice Address - Phone:650-762-8602
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-24
Last Update Date:2015-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA82973106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist