Provider Demographics
NPI:1972034551
Name:CASTILLO, CARINA EVELYN (LMFT)
Entity type:Individual
Prefix:
First Name:CARINA
Middle Name:EVELYN
Last Name:CASTILLO
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:CARINA
Other - Middle Name:EVELYN
Other - Last Name:RAMIREZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:216 S CITRUS ST STE 29
Mailing Address - Street 2:
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91791-2144
Mailing Address - Country:US
Mailing Address - Phone:626-342-0414
Mailing Address - Fax:
Practice Address - Street 1:11845 WEST OLYMPIC BLD
Practice Address - Street 2:SUITE 1050W
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90064
Practice Address - Country:US
Practice Address - Phone:626-342-0414
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-24
Last Update Date:2022-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA109249101YM0800X, 106H00000X
101YM0800X
CA132758106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty