Healthcare Provider Details

I. General information

NPI: 1154249472
Provider Name (Legal Business Name): JOANNE CAMILLE CASTRO FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5353 MISSION CENTER RD
SAN DIEGO CA
92108-1306
US

IV. Provider business mailing address

5353 MISSION CENTER RD STE 300
SAN DIEGO CA
92108-1305
US

V. Phone/Fax

Practice location:
  • Phone: 619-718-9655
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number95038723
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: