Provider Demographics
NPI:1487009965
Name:CASTILLO, STEPHEN NATHAN (M ED, PPS)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:NATHAN
Last Name:CASTILLO
Suffix:
Gender:M
Credentials:M ED, PPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41815 ROAD 128
Mailing Address - Street 2:
Mailing Address - City:OROSI
Mailing Address - State:CA
Mailing Address - Zip Code:93647-2008
Mailing Address - Country:US
Mailing Address - Phone:559-528-4731
Mailing Address - Fax:
Practice Address - Street 1:41815 ROAD 128
Practice Address - Street 2:
Practice Address - City:OROSI
Practice Address - State:CA
Practice Address - Zip Code:93647-2008
Practice Address - Country:US
Practice Address - Phone:559-528-4731
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-03
Last Update Date:2025-06-16
Deactivation Date:2025-05-19
Deactivation Code:
Reactivation Date:2025-06-11
Provider Licenses
StateLicense IDTaxonomies
220182371101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health