Healthcare Provider Details

I. General information

NPI: 1851919666
Provider Name (Legal Business Name): YOLANDA CASTANEDA ASW, MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2020
Last Update Date: 03/01/2021
Certification Date: 03/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2440 TULARE ST STE 200
FRESNO CA
93721-2281
US

IV. Provider business mailing address

2440 TULARE ST STE 200
FRESNO CA
93721-2281
US

V. Phone/Fax

Practice location:
  • Phone: 559-443-4800
  • Fax:
Mailing address:
  • Phone: 559-443-4800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberASW88458
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: