Provider Demographics
NPI:1841477601
Name:CASTILLO, TERESA MORALES (CAAR CERTIFIED)
Entity type:Individual
Prefix:MRS
First Name:TERESA
Middle Name:MORALES
Last Name:CASTILLO
Suffix:
Gender:F
Credentials:CAAR CERTIFIED
Other - Prefix:MRS
Other - First Name:TERESA
Other - Middle Name:MORALES
Other - Last Name:CASTILLO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CAAR CERTIFIED
Mailing Address - Street 1:1232 WESTWIND DR
Mailing Address - Street 2:
Mailing Address - City:EL CENTRO
Mailing Address - State:CA
Mailing Address - Zip Code:92243-4368
Mailing Address - Country:US
Mailing Address - Phone:760-353-2785
Mailing Address - Fax:760-357-2293
Practice Address - Street 1:535 CESAR CHAVEZ BLVD
Practice Address - Street 2:
Practice Address - City:CALEXICO
Practice Address - State:CA
Practice Address - Zip Code:92231-2103
Practice Address - Country:US
Practice Address - Phone:760-353-2785
Practice Address - Fax:760-357-2293
Is Sole Proprietor?:No
Enumeration Date:2008-01-23
Last Update Date:2008-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHDC70113F101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)