Provider Demographics
NPI:1619775350
Name:IBARRA CASTILLO, SYLVIA B
Entity type:Individual
Prefix:
First Name:SYLVIA
Middle Name:B
Last Name:IBARRA CASTILLO
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1259 SUNNY CT APT 24
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95116-2843
Mailing Address - Country:US
Mailing Address - Phone:408-375-9071
Mailing Address - Fax:
Practice Address - Street 1:1259 SUNNY CT APT 24
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95116-2843
Practice Address - Country:US
Practice Address - Phone:408-375-9071
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-07
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician