Provider Demographics
NPI:1730540782
Name:CASTILLO, CANDELARIO JACK III (LCSW)
Entity type:Individual
Prefix:MR
First Name:CANDELARIO
Middle Name:JACK
Last Name:CASTILLO
Suffix:III
Gender:M
Credentials:LCSW
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Mailing Address - Street 1:1420 WILLOW PASS RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94520-5823
Mailing Address - Country:US
Mailing Address - Phone:925-521-5159
Mailing Address - Fax:925-646-5622
Practice Address - Street 1:1420 WILLOW PASS RD
Practice Address - Street 2:SUITE 200
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-5823
Practice Address - Country:US
Practice Address - Phone:925-521-5159
Practice Address - Fax:925-646-5622
Is Sole Proprietor?:No
Enumeration Date:2016-03-17
Last Update Date:2017-10-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA799361041C0700X
CAASW 365151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical