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NPI Code Detail

MEDICARE: MR. EDWARD ARTHUR CASTRO M.A. IN PSYCHOLOGY

MEDICARE: MR. EDWARD ARTHUR CASTRO M.A. IN PSYCHOLOGY
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
1101YM0800XMental Health Counselor
2106H00000XMarriage & Family Therapist138477CA

General Provider Information

NPI Number : 1538216692
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. EDWARD ARTHUR CASTRO M.A. IN PSYCHOLOGY
Provider Business Mailing Address
First Line : 341 IRWIN LN
Second Line :
City : SANTA ROSA
State : CA
Zip : 95401-5603
Country : US
Telephone Number : 707-360-1500
Fax Number :
Provider Business Practice Location Address
First Line : 341 IRWIN LN
Second Line :
City : SANTA ROSA
State : CA
Zip : 95401-5603
Country : US
Telephone Number : 707-360-1500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/04/2007
Last Update Date : 05/21/2024

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