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NPI Code Detail

MEDICARE: TANEAKA CASTILLO

MEDICARE: TANEAKA CASTILLO
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
1372600000XAdult Companion
2101YP2500XProfessional CounselorASW137045CA
3171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1568009629
Entity Type Code : Individual
Provider Name (Legal Business Name) : TANEAKA CASTILLO
Provider Business Mailing Address
First Line : 2513 YOUNGSTOWN RD
Second Line :
City : TURLOCK
State : CA
Zip : 95380-9707
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2513 YOUNGSTOWN RD
Second Line :
City : TURLOCK
State : CA
Zip : 95380-9707
Country : US
Telephone Number : 209-678-3337
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/06/2019
Last Update Date : 03/04/2026

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Directions to “ TANEAKA CASTILLO ” Practice Location

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