Provider Demographics
NPI:1033704325
Name:CASTRO, YOLANDA (RDN)
Entity Type:Individual
Prefix:
First Name:YOLANDA
Middle Name:
Last Name:CASTRO
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4781 KENT CIR
Mailing Address - Street 2:
Mailing Address - City:LA PALMA
Mailing Address - State:CA
Mailing Address - Zip Code:90623-2018
Mailing Address - Country:US
Mailing Address - Phone:310-902-3103
Mailing Address - Fax:
Practice Address - Street 1:4781 KENT CIR
Practice Address - Street 2:
Practice Address - City:LA PALMA
Practice Address - State:CA
Practice Address - Zip Code:90623-2018
Practice Address - Country:US
Practice Address - Phone:310-902-3103
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-08
Last Update Date:2021-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86151942133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered