Provider Demographics
NPI:1497180590
Name:CASTILLO, YVETTE
Entity Type:Individual
Prefix:
First Name:YVETTE
Middle Name:
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 1:4373 VALLEY REGAL WAY
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89032-2606
Mailing Address - Country:US
Mailing Address - Phone:424-203-9333
Mailing Address - Fax:
Practice Address - Street 1:4373 VALLEY REGAL WAY
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89032-2606
Practice Address - Country:US
Practice Address - Phone:424-203-9333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-07
Last Update Date:2013-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner