Provider Demographics
NPI:1124315502
Name:CASTRO, JUDITH ANA (LMFT, LMT)
Entity type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:ANA
Last Name:CASTRO
Suffix:
Gender:F
Credentials:LMFT, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 E 24TH AVE
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97405-2907
Mailing Address - Country:US
Mailing Address - Phone:541-515-0900
Mailing Address - Fax:
Practice Address - Street 1:5 E 24TH AVE
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97405-2907
Practice Address - Country:US
Practice Address - Phone:541-515-0900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-06
Last Update Date:2020-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR18116225700000X
ORT1117106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist