Provider Demographics
NPI:1962714055
Name:CASTILLO, SYLVIA (PSYCH TECH)
Entity type:Individual
Prefix:
First Name:SYLVIA
Middle Name:
Last Name:CASTILLO
Suffix:
Gender:F
Credentials:PSYCH TECH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1020 S ARROYO PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105-3973
Mailing Address - Country:US
Mailing Address - Phone:626-403-4888
Mailing Address - Fax:
Practice Address - Street 1:1020 S ARROYO PKWY STE 100
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-3973
Practice Address - Country:US
Practice Address - Phone:626-403-4888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-06
Last Update Date:2010-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 35554167G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes167G00000XNursing Service ProvidersLicensed Psychiatric Technician