Healthcare Provider Details

I. General information

NPI: 1558295865
Provider Name (Legal Business Name): AMANDA CASTRO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 CLINTON ST
WOONSOCKET RI
02895-3245
US

IV. Provider business mailing address

38 SUMMIT AVE
WEST WARWICK RI
02893-4320
US

V. Phone/Fax

Practice location:
  • Phone: 401-235-7000
  • Fax:
Mailing address:
  • Phone: 401-235-7000
  • Fax: 401-283-7985

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN82417
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License NumberRN82417
License Number StateRI
# 3
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberRN82417
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: