Provider Demographics
NPI:1093943573
Name:CASTRO, SARA G
Entity Type:Individual
Prefix:MRS
First Name:SARA
Middle Name:G
Last Name:CASTRO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1191 CENTRAL BLVD
Mailing Address - Street 2:SUITE # A
Mailing Address - City:BRENTWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:94513-2279
Mailing Address - Country:US
Mailing Address - Phone:925-634-4445
Mailing Address - Fax:925-634-6235
Practice Address - Street 1:1191 CENTRAL BLVD
Practice Address - Street 2:SUITE # A
Practice Address - City:BRENTWOOD
Practice Address - State:CA
Practice Address - Zip Code:94513-2279
Practice Address - Country:US
Practice Address - Phone:925-634-4445
Practice Address - Fax:925-634-6235
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-23
Last Update Date:2009-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA942751073OtherFAMILLIAS UNIDAS