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General NPI Number Information
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NPI Number | 1124336953
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Entity Type | Individual
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Provider Name | RUDOLFO CASTRO LCSW
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Gender | Male
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Dates
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Enumeration Date | 09/14/2010
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Last Update Date | 02/23/2025
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Provider Practice Location Address
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Address Line | 4221 WILSHIRE BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90010-3512
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Country | US
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Telephone | 213-677-7005
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3102
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City | LANDERS
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State | CA
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Zip | 92285-0102
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225400000X
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Taxonomy Name | Rehabilitation Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCSW99038
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License Number State | CA
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