Provider Demographics
NPI:1174779466
Name:CASTILLO, KATHLEEN (MFT)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:
Last Name:CASTILLO
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:KATHLEEN
Other - Middle Name:
Other - Last Name:HAUANIO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:91-771 ONEULA PL
Mailing Address - Street 2:
Mailing Address - City:EWA BEACH
Mailing Address - State:HI
Mailing Address - Zip Code:96706-2511
Mailing Address - Country:US
Mailing Address - Phone:808-347-6867
Mailing Address - Fax:808-689-3922
Practice Address - Street 1:91-771 ONEULA PL
Practice Address - Street 2:
Practice Address - City:EWA BEACH
Practice Address - State:HI
Practice Address - Zip Code:96706-2511
Practice Address - Country:US
Practice Address - Phone:808-347-6867
Practice Address - Fax:808-689-3922
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-18
Last Update Date:2011-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist