Provider Demographics
NPI:1053888743
Name:CASTILLO, ABUNDIO (FNP)
Entity type:Individual
Prefix:
First Name:ABUNDIO
Middle Name:
Last Name:CASTILLO
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 E NORTH ST
Mailing Address - Street 2:
Mailing Address - City:TAFT
Mailing Address - State:CA
Mailing Address - Zip Code:93268-3606
Mailing Address - Country:US
Mailing Address - Phone:661-765-1935
Mailing Address - Fax:661-765-7234
Practice Address - Street 1:4821 PANAMA LN
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93313-3480
Practice Address - Country:US
Practice Address - Phone:661-556-4777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-31
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95010344363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily