Provider Demographics
NPI:1508646241
Name:CASTILLO, JENNIFER ROCIO (BS)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ROCIO
Last Name:CASTILLO
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 NW CENTRAL PARK PLZ
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34986-1825
Mailing Address - Country:US
Mailing Address - Phone:772-303-1987
Mailing Address - Fax:
Practice Address - Street 1:160 NW CENTRAL PARK PLZ
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34986-1825
Practice Address - Country:US
Practice Address - Phone:414-803-8855
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-02
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical