Healthcare Provider Details

I. General information

NPI: 1659989184
Provider Name (Legal Business Name): NATALIE ZULEIMA AZURDIA CASTRO LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2020
Last Update Date: 02/10/2025
Certification Date: 02/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3280 E FOOTHILL BLVD
PASADENA CA
91107-3148
US

IV. Provider business mailing address

PO BOX 4593
COVINA CA
91723-4593
US

V. Phone/Fax

Practice location:
  • Phone: 323-254-2274
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number97435
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number119880
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: