Provider Demographics
NPI:1952807406
Name:CASTELLO, MICHAELA ANNE (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:MICHAELA
Middle Name:ANNE
Last Name:CASTELLO
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:DR
Other - First Name:MICHAEL
Other - Middle Name:ANTHONY
Other - Last Name:CASTELLO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD, PHD
Mailing Address - Street 1:3020 CHILDRENS WAY # MC5009
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-4223
Mailing Address - Country:US
Mailing Address - Phone:858-966-5819
Mailing Address - Fax:
Practice Address - Street 1:3020 CHILDRENS WAY # MC5009
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-4223
Practice Address - Country:US
Practice Address - Phone:858-966-5819
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-03
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1648142084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology