Provider Demographics
NPI:1669870010
Name:CASTRO, NATALIE KEOMAILANI ORNELLAS (LCSW)
Entity type:Individual
Prefix:MS
First Name:NATALIE
Middle Name:KEOMAILANI ORNELLAS
Last Name:CASTRO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:NATALIE
Other - Middle Name:KEOMAILANI
Other - Last Name:ORNELLAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:TRIPLER ARMY MEDICAL CENTER CREDENTIALING DEPARTMENT
Mailing Address - Street 2:1 JARRETT WHITE ROAD
Mailing Address - City:TRIPLER AMC
Mailing Address - State:HI
Mailing Address - Zip Code:96859-5000
Mailing Address - Country:US
Mailing Address - Phone:808-433-8134
Mailing Address - Fax:
Practice Address - Street 1:315 BRANNON ROAD
Practice Address - Street 2:BUILDING 674 - ROOM 2032 - DESMOND DOSS HEALTH CLINIC
Practice Address - City:SCHOFIELD BARRACKS
Practice Address - State:HI
Practice Address - Zip Code:96857-5460
Practice Address - Country:US
Practice Address - Phone:808-433-8134
Practice Address - Fax:808-433-8597
Is Sole Proprietor?:No
Enumeration Date:2014-12-17
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI39701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical