Provider Demographics
NPI:1295572733
Name:DEL CASTILLO, JUSTIN BENEDICT LAYUGAN
Entity type:Individual
Prefix:
First Name:JUSTIN BENEDICT
Middle Name:LAYUGAN
Last Name:DEL CASTILLO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2940 BERKSHIRE DR
Mailing Address - Street 2:
Mailing Address - City:SAN BRUNO
Mailing Address - State:CA
Mailing Address - Zip Code:94066-1756
Mailing Address - Country:US
Mailing Address - Phone:650-271-3303
Mailing Address - Fax:
Practice Address - Street 1:2940 BERKSHIRE DR
Practice Address - Street 2:
Practice Address - City:SAN BRUNO
Practice Address - State:CA
Practice Address - Zip Code:94066-1756
Practice Address - Country:US
Practice Address - Phone:650-271-3303
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-11
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker