Provider Demographics
NPI:1336526003
Name:CASTELLON, CAROL NAHYMA (BCBA)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:NAHYMA
Last Name:CASTELLON
Suffix:
Gender:
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7840 FOOTHILL BLVD STE H
Mailing Address - Street 2:
Mailing Address - City:SUNLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91040-2907
Mailing Address - Country:US
Mailing Address - Phone:818-273-9802
Mailing Address - Fax:855-743-1238
Practice Address - Street 1:7840 FOOTHILL BLVD STE H
Practice Address - Street 2:
Practice Address - City:SUNLAND
Practice Address - State:CA
Practice Address - Zip Code:91040-2907
Practice Address - Country:US
Practice Address - Phone:818-273-9802
Practice Address - Fax:855-743-1238
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-01
Last Update Date:2025-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
252Y00000X
CA1-15-18014103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No252Y00000XAgenciesEarly Intervention Provider Agency