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NPI Code Detail

MEDICARE: PERCY RAYNIER CASTELLANOS B.A.

MEDICARE: PERCY RAYNIER CASTELLANOS B.A.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial WorkerASW31571CA
21041C0700XClinical Social WorkerLCSW 64671CA

General Provider Information

NPI Number : 1518127471
Entity Type Code : Individual
Provider Name (Legal Business Name) : PERCY RAYNIER CASTELLANOS B.A.
Provider Business Mailing Address
First Line : 3101 TELEGRAPH AVE FL 2
Second Line :
City : BERKELEY
State : CA
Zip : 94705-1984
Country : US
Telephone Number : 510-924-4838
Fax Number :
Provider Business Practice Location Address
First Line : 3101 TELEGRAPH AVE FL 2
Second Line :
City : BERKELEY
State : CA
Zip : 94705-1984
Country : US
Telephone Number : 510-924-4838
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/13/2008
Last Update Date : 10/07/2021

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Directions to “ PERCY RAYNIER CASTELLANOS B.A.” Practice Location

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