Provider Demographics
NPI:1568505550
Name:CASTILLO, ARACELI GUTIERREZ
Entity Type:Individual
Prefix:
First Name:ARACELI
Middle Name:GUTIERREZ
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 1:315 E GREVILLEA ST
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91761-5322
Mailing Address - Country:US
Mailing Address - Phone:909-988-8901
Mailing Address - Fax:
Practice Address - Street 1:2990 INLAND EMPIRE BLVD
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91764-4899
Practice Address - Country:US
Practice Address - Phone:909-980-3427
Practice Address - Fax:909-945-3426
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner