MEDICARE: MARIA A CASTRO

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
1	172V00000X	Community Health Worker		CA

General Provider Information

NPI Number	:	1801678784
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA A CASTRO

Provider Business Mailing Address
First Line	:	2962 LOS ALTOS WAY
Second Line	:
City	:	ANTIOCH
State	:	CA
Zip	:	94509-4529
Country	:	US
Telephone Number	:	415-505-4145
Fax Number	:

Provider Business Practice Location Address
First Line	:	2962 LOS ALTOS WAY
Second Line	:
City	:	ANTIOCH
State	:	CA
Zip	:	94509-4529
Country	:	US
Telephone Number	:	415-505-4145
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/16/2023
Last Update Date	:	10/16/2023

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Directions to “ MARIA A CASTRO ” Practice Location

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