Healthcare Provider Details

I. General information

NPI: 1629913223
Provider Name (Legal Business Name): DR. JUAN CASTRO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2026
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10538 MISSION GORGE RD STE 120
SANTEE CA
92071-3154
US

IV. Provider business mailing address

2930 BARNARD ST UNIT 6301
SAN DIEGO CA
92110-5767
US

V. Phone/Fax

Practice location:
  • Phone: 619-312-6109
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: