MEDICARE: SARA CASTRO FSP

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1306957139
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARA CASTRO FSP

Provider Business Mailing Address
First Line	:	9445 FARNHAM ST STE 100
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92123-1399
Country	:	US
Telephone Number	:	858-380-4676
Fax Number	:

Provider Business Practice Location Address
First Line	:	1840 WILSON AVE STE C
Second Line	:
City	:	NATIONAL CITY
State	:	CA
Zip	:	91950-5515
Country	:	US
Telephone Number	:	619-477-0242
Fax Number	:	619-477-0799

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

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	11/09/2020

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Directions to “ SARA CASTRO FSP” Practice Location

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