Provider Demographics
NPI:1952966616
Name:CASTELLANOS, CRISTIAN JOHN
Entity type:Individual
Prefix:
First Name:CRISTIAN
Middle Name:JOHN
Last Name:CASTELLANOS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:440 POTRERO AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-1430
Mailing Address - Country:US
Mailing Address - Phone:415-487-6722
Mailing Address - Fax:415-487-6724
Practice Address - Street 1:440 POTRERO AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-1430
Practice Address - Country:US
Practice Address - Phone:415-487-6722
Practice Address - Fax:415-487-6724
Is Sole Proprietor?:No
Enumeration Date:2019-05-07
Last Update Date:2019-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)