Provider Demographics
NPI:1538637715
Name:CASTILLO ARCE, EFREN
Entity Type:Individual
Prefix:
First Name:EFREN
Middle Name:
Last Name:CASTILLO ARCE
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 1:1231 E DYER RD STE 275
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-5668
Mailing Address - Country:US
Mailing Address - Phone:714-944-8010
Mailing Address - Fax:
Practice Address - Street 1:16580 HARBOR BLVD STE M
Practice Address - Street 2:
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-1385
Practice Address - Country:US
Practice Address - Phone:714-559-2256
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-06
Last Update Date:2020-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101YM0800X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health