Provider Demographics
NPI:1902540842
Name:CASTILLON, ESPY SARAHI
Entity Type:Individual
Prefix:
First Name:ESPY
Middle Name:SARAHI
Last Name:CASTILLON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3066 SOUTHERN AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH GATE
Mailing Address - State:CA
Mailing Address - Zip Code:90280-2834
Mailing Address - Country:US
Mailing Address - Phone:323-331-1177
Mailing Address - Fax:
Practice Address - Street 1:3756 SANTA ROSALIA DR STE 424
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90008-3614
Practice Address - Country:US
Practice Address - Phone:323-596-3147
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-26
Last Update Date:2022-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator