Provider Demographics
NPI:1548386691
Name:CASTILLO-SOTO, VIRGINIA (MFTI)
Entity Type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:
Last Name:CASTILLO-SOTO
Suffix:
Gender:F
Credentials:MFTI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11731 E. TELEGRAPH RD
Mailing Address - Street 2:BUILDING G
Mailing Address - City:SANTA FE SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:90670
Mailing Address - Country:US
Mailing Address - Phone:562-942-8256
Mailing Address - Fax:562-942-9789
Practice Address - Street 1:11731 E. TELEGRAPH RD
Practice Address - Street 2:BUILDING G
Practice Address - City:SANTA FE SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:90670
Practice Address - Country:US
Practice Address - Phone:562-942-8256
Practice Address - Fax:562-942-9789
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2011-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF52103101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health