Provider Demographics
NPI:1336526003
Name:CASTELLON, CAROL NAHYMA (BCBA)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:NAHYMA
Last Name:CASTELLON
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7840 FOOTHILL BLVD STE E
Mailing Address - Street 2:
Mailing Address - City:SUNLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91040-2907
Mailing Address - Country:US
Mailing Address - Phone:818-875-4328
Mailing Address - Fax:888-869-4002
Practice Address - Street 1:14500 ROSCOE BLVD STE 400
Practice Address - Street 2:
Practice Address - City:PANORAMA CITY
Practice Address - State:CA
Practice Address - Zip Code:91402-4194
Practice Address - Country:US
Practice Address - Phone:818-714-2152
Practice Address - Fax:888-269-1330
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-15-18014103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst