Provider Demographics
NPI:1568294353
Name:CASTRO, LILIA (NP)
Entity type:Individual
Prefix:
First Name:LILIA
Middle Name:
Last Name:CASTRO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35665 GENTIAN LN
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-2813
Mailing Address - Country:US
Mailing Address - Phone:951-663-6586
Mailing Address - Fax:
Practice Address - Street 1:40700 CALIFORNIA OAKS RD STE 206
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-5789
Practice Address - Country:US
Practice Address - Phone:951-412-0011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-19
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95031736363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily