Provider Demographics
NPI:1932971660
Name:CASTELLANOS, GALILEA SOPHIA
Entity Type:Individual
Prefix:
First Name:GALILEA
Middle Name:SOPHIA
Last Name:CASTELLANOS
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 1:10263 OLEANDER AVE
Mailing Address - Street 2:
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92335-7812
Mailing Address - Country:US
Mailing Address - Phone:626-747-3479
Mailing Address - Fax:
Practice Address - Street 1:10263 OLEANDER AVE
Practice Address - Street 2:
Practice Address - City:FONTANA
Practice Address - State:CA
Practice Address - Zip Code:92335-7812
Practice Address - Country:US
Practice Address - Phone:626-747-3479
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-25
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician