Provider Demographics
NPI:1306402581
Name:CASTELLO, ANA M
Entity type:Individual
Prefix:
First Name:ANA
Middle Name:M
Last Name:CASTELLO
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:ANA
Other - Middle Name:M
Other - Last Name:CASTILLO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CASTILLO
Mailing Address - Street 1:317 E D ST
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91764-4142
Mailing Address - Country:US
Mailing Address - Phone:909-975-1660
Mailing Address - Fax:
Practice Address - Street 1:317 E DTH STREET
Practice Address - Street 2:317 E DTH STREET UNIT A
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91764-4142
Practice Address - Country:US
Practice Address - Phone:909-975-1660
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-14
Last Update Date:2019-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator