Provider Demographics
NPI:1316327901
Name:CASTRO, QUISHA M (LMFT)
Entity type:Individual
Prefix:
First Name:QUISHA
Middle Name:M
Last Name:CASTRO
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:QUISHA
Other - Middle Name:M
Other - Last Name:CASTRO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MFTI
Mailing Address - Street 1:12440 FIRESTONE BLVD STE 3020
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CA
Mailing Address - Zip Code:90650-9328
Mailing Address - Country:US
Mailing Address - Phone:562-864-7821
Mailing Address - Fax:
Practice Address - Street 1:12440 E FIREDSTONE BLVD
Practice Address - Street 2:3020
Practice Address - City:NORWALK
Practice Address - State:CA
Practice Address - Zip Code:90650-9331
Practice Address - Country:US
Practice Address - Phone:562-864-7821
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-09
Last Update Date:2020-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA66822106H00000X
CA119317106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist