Provider Demographics
NPI:1730312034
Name:CASTILLO, OSBALDO (LVN)
Entity Type:Individual
Prefix:
First Name:OSBALDO
Middle Name:
Last Name:CASTILLO
Suffix:
Gender:M
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:138 S L ST
Mailing Address - Street 2:
Mailing Address - City:DINUBA
Mailing Address - State:CA
Mailing Address - Zip Code:93618-2323
Mailing Address - Country:US
Mailing Address - Phone:559-596-0200
Mailing Address - Fax:559-596-0500
Practice Address - Street 1:138 S L ST
Practice Address - Street 2:
Practice Address - City:DINUBA
Practice Address - State:CA
Practice Address - Zip Code:93618-2323
Practice Address - Country:US
Practice Address - Phone:559-596-0200
Practice Address - Fax:559-596-0500
Is Sole Proprietor?:No
Enumeration Date:2009-09-02
Last Update Date:2009-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN 177684164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse