Healthcare Provider Details

I. General information

NPI: 1144486218
Provider Name (Legal Business Name): SANDRA CASTRO B.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2008
Last Update Date: 06/13/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

942 E CHAPMAN AVE
ORANGE CA
92866-2109
US

IV. Provider business mailing address

942 E CHAPMAN AVE
ORANGE CA
92866-2109
US

V. Phone/Fax

Practice location:
  • Phone: 714-399-1860
  • Fax: 714-399-1867
Mailing address:
  • Phone: 714-399-1860
  • Fax: 714-399-1867

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: