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General NPI Number Information
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NPI Number | 1285188797
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Entity Type | Individual
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Provider Name | NICOLE CASTREJON LCSW
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Gender | Female
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Dates
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Enumeration Date | 08/12/2016
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Last Update Date | 06/21/2017
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Provider Practice Location Address
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Address Line | 3725 COOLIDGE AVE
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City | OAKLAND
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State | CA
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Zip | 94602-3308
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Country | US
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Telephone | 408-416-7118
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Fax |
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Provider Business Mailing Address
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Address Line | 4796 HEYER AVE APT 4
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City | CASTRO VALLEY
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State | CA
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Zip | 94546-3657
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Country | US
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Telephone | 408-416-7118
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCSW71810
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License Number State | CA
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