Provider Demographics
NPI:1396102729
Name:DEL CASTILLO, MARIA ASUNCION MULLEDA (PTRP, PTA)
Entity type:Individual
Prefix:
First Name:MARIA ASUNCION
Middle Name:MULLEDA
Last Name:DEL CASTILLO
Suffix:
Gender:F
Credentials:PTRP, PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 602
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:DE
Mailing Address - Zip Code:19720-0602
Mailing Address - Country:US
Mailing Address - Phone:707-334-8402
Mailing Address - Fax:
Practice Address - Street 1:2121 PINE ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-2829
Practice Address - Country:US
Practice Address - Phone:415-922-5085
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-14
Last Update Date:2016-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAT-8866171M00000X
DEJ2-0000627171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator