MEDICARE: FABRIENNE CASTRO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	9077668-3503	UT
2	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1154283919
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FABRIENNE CASTRO

Provider Business Mailing Address
First Line	:	826 W 450 N
Second Line	:
City	:	OREM
State	:	UT
Zip	:	84057-3602
Country	:	US
Telephone Number	:	385-375-4081
Fax Number	:

Provider Business Practice Location Address
First Line	:	7533 S CENTER VIEW CT # 5150
Second Line	:
City	:	WEST JORDAN
State	:	UT
Zip	:	84084-5526
Country	:	US
Telephone Number	:	801-214-8070
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/01/2025
Last Update Date	:	12/05/2025

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Directions to “ FABRIENNE CASTRO ” Practice Location

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