Healthcare Provider Details

I. General information

NPI: 1245113703
Provider Name (Legal Business Name): CARILIA CASTRO-MARTINEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/30/2025
Last Update Date: 07/30/2025
Certification Date: 07/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1229 WOODLAND DR
SANTA PAULA CA
93060-1256
US

IV. Provider business mailing address

1229 WOODLAND DR
SANTA PAULA CA
93060-1256
US

V. Phone/Fax

Practice location:
  • Phone: 323-528-8230
  • Fax:
Mailing address:
  • Phone: 323-528-8230
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0102X
TaxonomyMaternal Newborn Registered Nurse
License Number554679
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: