Provider Demographics
NPI:1720805971
Name:CASTRO NESBITT, NOELLE MICHELE (ACSW)
Entity type:Individual
Prefix:
First Name:NOELLE
Middle Name:MICHELE
Last Name:CASTRO NESBITT
Suffix:
Gender:F
Credentials:ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4075 TWINING ST
Mailing Address - Street 2:
Mailing Address - City:JURUPA VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92509-6758
Mailing Address - Country:US
Mailing Address - Phone:951-990-2497
Mailing Address - Fax:
Practice Address - Street 1:460 E ALGROVE ST
Practice Address - Street 2:
Practice Address - City:COVINA
Practice Address - State:CA
Practice Address - Zip Code:91723-2707
Practice Address - Country:US
Practice Address - Phone:818-723-9559
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-20
Last Update Date:2024-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA99004101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health