Healthcare Provider Details

I. General information

NPI: 1831934199
Provider Name (Legal Business Name): CYNTHIA M CASTRO FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2024
Last Update Date: 10/29/2025
Certification Date: 10/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11024 VICTORY BLVD
NORTH HOLLYWOOD CA
91606-3720
US

IV. Provider business mailing address

19507 ASTOR PL
NORTHRIDGE CA
91324-1673
US

V. Phone/Fax

Practice location:
  • Phone: 818-503-9800
  • Fax: 818-503-9801
Mailing address:
  • Phone: 774-386-7425
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95036106
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN95255256
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: