Provider Demographics
NPI:1700372158
Name:CASTILLO, ARLENE (MS)
Entity Type:Individual
Prefix:MRS
First Name:ARLENE
Middle Name:
Last Name:CASTILLO
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:711 KENWOOD STREET
Mailing Address - Street 2:
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91784-0800
Mailing Address - Country:US
Mailing Address - Phone:909-989-9030
Mailing Address - Fax:909-466-4594
Practice Address - Street 1:9033 BASELINE RD.
Practice Address - Street 2:SUITE 5
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-1214
Practice Address - Country:US
Practice Address - Phone:909-989-9030
Practice Address - Fax:909-466-4594
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-09
Last Update Date:2019-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA99945106H00000X
107466106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist