Provider Demographics
NPI:1083054134
Name:CASTILLO, SHARELL LAKEE
Entity Type:Individual
Prefix:
First Name:SHARELL
Middle Name:LAKEE
Last Name:CASTILLO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2122 S EL CAMINO REAL STE 102
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92054-6209
Mailing Address - Country:US
Mailing Address - Phone:760-290-8170
Mailing Address - Fax:760-439-0019
Practice Address - Street 1:2122 S EL CAMINO REAL STE 102
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92054-6209
Practice Address - Country:US
Practice Address - Phone:760-290-8170
Practice Address - Fax:760-439-0019
Is Sole Proprietor?:No
Enumeration Date:2013-07-02
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No101Y00000XBehavioral Health & Social Service ProvidersCounselor