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NPI Code Detail

MEDICARE: MS. GLENDA CASTRO FNP-C, PMHNP-BC

MEDICARE: MS. GLENDA CASTRO FNP-C, PMHNP-BC
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
1363LF0000XFamily Nurse Practitioner14804CA
2390200000XStudent in an Organized Health Care Education/Training Program
3363LP0808XPsychiatric/Mental Health Nurse Practitioner14804CA

General Provider Information

NPI Number : 1619145059
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. GLENDA CASTRO FNP-C, PMHNP-BC
Provider Business Mailing Address
First Line : 453 E WIND DR
Second Line :
City : RIPON
State : CA
Zip : 95366-9456
Country : US
Telephone Number : 209-599-1527
Fax Number :
Provider Business Practice Location Address
First Line : 1225 OAKDALE RD
Second Line :
City : MODESTO
State : CA
Zip : 95355-3357
Country : US
Telephone Number : 209-557-6200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/20/2008
Last Update Date : 01/22/2021

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