Provider Demographics
NPI:1780331199
Name:CASTILLO, CHRISTINE VICTORIA (RDN)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:VICTORIA
Last Name:CASTILLO
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:442 ELDORADO DR
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92025-6225
Mailing Address - Country:US
Mailing Address - Phone:760-445-4357
Mailing Address - Fax:
Practice Address - Street 1:442 ELDORADO DR
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-6225
Practice Address - Country:US
Practice Address - Phone:760-445-4357
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-05
Last Update Date:2022-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86170518133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered