Basic Information
| Provider Information | |||||||||
| NPI: | 1609360296 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CASILLAS | ||||||||
| FirstName: | ALMA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3751 STOCKER ST | ||||||||
| Address2: | |||||||||
| City: | VIEW PARK | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900085101 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3232983680 | ||||||||
| FaxNumber: | 3232920053 | ||||||||
| Practice Location | |||||||||
| Address1: | 3751 STOCKER ST | ||||||||
| Address2: | |||||||||
| City: | VIEW PARK | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900085101 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3232983680 | ||||||||
| FaxNumber: | 3232920053 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/18/2018 | ||||||||
| LastUpdateDate: | 04/09/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/09/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 172M00000X | N | Other Service Providers | Mechanotherapist | 172V00000X | Y | Other Service Providers | Community Health Worker |
No ID Information.