Provider Demographics
NPI:1497197495
Name:CASTILLO, ALEJANDRO VELEZ
Entity Type:Individual
Prefix:MR
First Name:ALEJANDRO
Middle Name:VELEZ
Last Name:CASTILLO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5450 POWER INN RD STE B
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95820-6749
Mailing Address - Country:US
Mailing Address - Phone:530-848-4784
Mailing Address - Fax:
Practice Address - Street 1:5450 POWER INN RD STE B
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95820-6749
Practice Address - Country:US
Practice Address - Phone:916-388-9418
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-19
Last Update Date:2013-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor