Provider Demographics
NPI:1013094937
Name:CASTILLO-LOPEZ, NATASHA
Entity Type:Individual
Prefix:
First Name:NATASHA
Middle Name:
Last Name:CASTILLO-LOPEZ
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 1:43376 COOK ST
Mailing Address - Street 2:UNIT 138
Mailing Address - City:PALM DESERT
Mailing Address - State:CA
Mailing Address - Zip Code:92211-3128
Mailing Address - Country:US
Mailing Address - Phone:858-353-6340
Mailing Address - Fax:855-642-8280
Practice Address - Street 1:43376 COOK ST
Practice Address - Street 2:UNIT 138
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92211-3128
Practice Address - Country:US
Practice Address - Phone:858-353-6340
Practice Address - Fax:855-642-8280
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2014-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist