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NPI Code Detail

MEDICARE: YVETTE CASTANON

MEDICARE: YVETTE CASTANON
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
1390200000XStudent in an Organized Health Care Education/Training Program
21041C0700XClinical Social WorkerASW91655CA

General Provider Information

NPI Number : 1881028710
Entity Type Code : Individual
Provider Name (Legal Business Name) : YVETTE CASTANON
Provider Business Mailing Address
First Line : 1950 S SUNWEST LN
Second Line :
City : SAN BERNARDINO
State : CA
Zip : 92408-3258
Country : US
Telephone Number : 909-252-4010
Fax Number :
Provider Business Practice Location Address
First Line : 3924 RIVERVIEW DR
Second Line :
City : JURUPA VALLEY
State : CA
Zip : 92509-6611
Country : US
Telephone Number : 951-416-1572
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/27/2013
Last Update Date : 09/01/2020

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Directions to “ YVETTE CASTANON ” Practice Location

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