Provider Demographics
NPI:1346049392
Name:CASTILLO, LILY MARIE (RBT)
Entity type:Individual
Prefix:MRS
First Name:LILY
Middle Name:MARIE
Last Name:CASTILLO
Suffix:
Gender:
Credentials:RBT
Other - Prefix:MRS
Other - First Name:LILY
Other - Middle Name:MARIE
Other - Last Name:LYBOLT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RBT
Mailing Address - Street 1:6426 W 5TH ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048-4710
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6426 W 5TH ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-4710
Practice Address - Country:US
Practice Address - Phone:323-825-7172
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-12
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician