Healthcare Provider Details

I. General information

NPI: 1750153805
Provider Name (Legal Business Name): MONICA CASTRO CHW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/23/2023
Last Update Date: 10/23/2023
Certification Date: 10/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 CENTRAL AVE STE 230
RIVERSIDE CA
92506-2176
US

IV. Provider business mailing address

7946 CITADEL CT
RIVERSIDE CA
92503-3036
US

V. Phone/Fax

Practice location:
  • Phone: 951-781-6335
  • Fax:
Mailing address:
  • Phone: 951-901-5925
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: