Provider Demographics
NPI:1558251025
Name:CASTRO, AMELIA
Entity type:Individual
Prefix:
First Name:AMELIA
Middle Name:
Last Name:CASTRO
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 1:20325 SHERMAN WAY APT 46
Mailing Address - Street 2:
Mailing Address - City:WINNETKA
Mailing Address - State:CA
Mailing Address - Zip Code:91306-3140
Mailing Address - Country:US
Mailing Address - Phone:818-277-2412
Mailing Address - Fax:
Practice Address - Street 1:18144 BURBANK BLVD APT 1
Practice Address - Street 2:
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-2515
Practice Address - Country:US
Practice Address - Phone:818-277-2412
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-07
Last Update Date:2025-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education