Provider Demographics
NPI:1194002477
Name:CASTILLO, JOELLA MARGARITA (DC, CCSP)
Entity Type:Individual
Prefix:DR
First Name:JOELLA
Middle Name:MARGARITA
Last Name:CASTILLO
Suffix:
Gender:F
Credentials:DC, CCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4104 24TH ST
Mailing Address - Street 2:295
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94114-3615
Mailing Address - Country:US
Mailing Address - Phone:415-641-4892
Mailing Address - Fax:415-641-1327
Practice Address - Street 1:4167 26TH ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94131-1914
Practice Address - Country:US
Practice Address - Phone:415-641-4892
Practice Address - Fax:415-641-1327
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-14
Last Update Date:2011-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22305111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician