Provider Demographics
NPI:1538730056
Name:PANED, APRILLE LYN CASTILLEJOS
Entity type:Individual
Prefix:
First Name:APRILLE LYN
Middle Name:CASTILLEJOS
Last Name:PANED
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 1:91-1055 HANALOA ST
Mailing Address - Street 2:
Mailing Address - City:EWA BEACH
Mailing Address - State:HI
Mailing Address - Zip Code:96706-2834
Mailing Address - Country:US
Mailing Address - Phone:808-780-9325
Mailing Address - Fax:
Practice Address - Street 1:91-1055 HANALOA ST
Practice Address - Street 2:
Practice Address - City:EWA BEACH
Practice Address - State:HI
Practice Address - Zip Code:96706-2834
Practice Address - Country:US
Practice Address - Phone:808-780-9325
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-06
Last Update Date:2021-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RBT-20-109780106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician