Provider Demographics
NPI:1851793368
Name:CASTON, CHRIS ELMOR (LCSW)
Entity type:Individual
Prefix:MR
First Name:CHRIS
Middle Name:ELMOR
Last Name:CASTON
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:MR
Other - First Name:CHRISTOPHER
Other - Middle Name:ELMOR
Other - Last Name:CASTON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:9590 GRACE ST
Mailing Address - Street 2:
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92335-6146
Mailing Address - Country:US
Mailing Address - Phone:951-460-5592
Mailing Address - Fax:
Practice Address - Street 1:9590 GRACE ST
Practice Address - Street 2:
Practice Address - City:FONTANA
Practice Address - State:CA
Practice Address - Zip Code:92335-6146
Practice Address - Country:US
Practice Address - Phone:951-460-5592
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-16
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1245671041C0700X
CAASW90442101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical