Provider Demographics
NPI:1477677581
Name:CASTILLO, ALICE (CADC II)
Entity Type:Individual
Prefix:
First Name:ALICE
Middle Name:
Last Name:CASTILLO
Suffix:
Gender:F
Credentials:CADC II
Other - Prefix:
Other - First Name:ALICE
Other - Middle Name:
Other - Last Name:CASTILLO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CADC II
Mailing Address - Street 1:PO BOX 1000
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93302-1000
Mailing Address - Country:US
Mailing Address - Phone:661-868-6601
Mailing Address - Fax:661-868-6611
Practice Address - Street 1:1401 L ST
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-4522
Practice Address - Country:US
Practice Address - Phone:661-868-7151
Practice Address - Fax:661-868-0840
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2021-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA03750315101YA0400X, 171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)