Provider Demographics
NPI:1285886812
Name:BONILLA, SHARON CASTILLO (LMSW-IPR)
Entity type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:CASTILLO
Last Name:BONILLA
Suffix:
Gender:F
Credentials:LMSW-IPR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2707 TURQUOISE WAY
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78251-1730
Mailing Address - Country:US
Mailing Address - Phone:210-378-0601
Mailing Address - Fax:210-682-2601
Practice Address - Street 1:2707 TURQUOISE WAY
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78251-1730
Practice Address - Country:US
Practice Address - Phone:210-378-0601
Practice Address - Fax:210-682-2601
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-14
Last Update Date:2008-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX32260171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator