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General NPI Number Information
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NPI Number | 1710456769
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Entity Type | Individual
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Provider Name | SERGIO ALFREDO CASTANEDA MUNGUIA
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Gender | Male
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Dates
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Enumeration Date | 11/20/2018
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Last Update Date | 12/10/2025
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Provider Practice Location Address
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Address Line | 290 N D ST
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City | SAN BERNARDINO
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State | CA
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Zip | 92401-1734
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Country | US
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Telephone | 909-963-5355
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Fax | 909-313-2320
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Provider Business Mailing Address
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Address Line | 290 N D ST
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City | SAN BERNARDINO
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State | CA
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Zip | 92401-1734
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Country | US
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Telephone | 909-963-5355
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Fax | 909-313-2320
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 126568
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | ASW126568
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License Number State | CA
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