Provider Demographics
NPI:1699099127
Name:CASTELLANOS, JOSE R JR
Entity type:Individual
Prefix:MR
First Name:JOSE
Middle Name:R
Last Name:CASTELLANOS
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 CROW CANYON CT
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94583-1928
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1 CROW CANYON CT
Practice Address - Street 2:SUITE 100
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583-1928
Practice Address - Country:US
Practice Address - Phone:888-531-8385
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-26
Last Update Date:2014-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst