Provider Demographics
NPI:1740166180
Name:CASTILLEJO, CHRISTINA L (LAC, NCC)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:L
Last Name:CASTILLEJO
Suffix:
Gender:F
Credentials:LAC, NCC
Other - Prefix:
Other - First Name:XHRIS
Other - Middle Name:L
Other - Last Name:CASTILLEJO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LAC, NCC
Mailing Address - Street 1:8102 N 19TH DR APT T236
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85021-5135
Mailing Address - Country:US
Mailing Address - Phone:480-747-1214
Mailing Address - Fax:
Practice Address - Street 1:333 W ROOSEVELT ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85003-1324
Practice Address - Country:US
Practice Address - Phone:623-695-7980
Practice Address - Fax:602-691-0233
Is Sole Proprietor?:No
Enumeration Date:2025-08-12
Last Update Date:2025-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4178114101YS0200X
AZLAC-23612101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool