Provider Demographics
NPI:1679945869
Name:CASTILLO, JOCASTA (CSW)
Entity type:Individual
Prefix:
First Name:JOCASTA
Middle Name:
Last Name:CASTILLO
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8920 EAGLE BEND
Mailing Address - Street 2:
Mailing Address - City:HELOTES
Mailing Address - State:TX
Mailing Address - Zip Code:78023
Mailing Address - Country:US
Mailing Address - Phone:919-360-4075
Mailing Address - Fax:
Practice Address - Street 1:JEWISH FAMILY SERVICE OF SAN ANTONIO, TX, INC.
Practice Address - Street 2:12500 NW MILITARY HWY STE 250
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78231
Practice Address - Country:US
Practice Address - Phone:210-302-6920
Practice Address - Fax:210-302-6952
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-27
Last Update Date:2019-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010987651041C0700X
1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX67499Medicaid