Provider Demographics
NPI:1689308058
Name:DEL CASTILLO, SAMANTHA (PHD)
Entity type:Individual
Prefix:DR
First Name:SAMANTHA
Middle Name:
Last Name:DEL CASTILLO
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:SAM
Other - Middle Name:
Other - Last Name:DEL CASTILLO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:617 VETERANS BLVD STE 212
Mailing Address - Street 2:
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94063-1419
Mailing Address - Country:US
Mailing Address - Phone:650-240-3119
Mailing Address - Fax:
Practice Address - Street 1:617 VETERANS BLVD STE 212
Practice Address - Street 2:
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94063-1419
Practice Address - Country:US
Practice Address - Phone:832-289-8780
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-12
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY35496103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist