Provider Demographics
NPI:1548401656
Name:CASTRO, NOELIA C (LVN)
Entity Type:Individual
Prefix:
First Name:NOELIA
Middle Name:C
Last Name:CASTRO
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5957 S MOONEY BLVD
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93277-9394
Mailing Address - Country:US
Mailing Address - Phone:559-737-4660
Mailing Address - Fax:559-737-4697
Practice Address - Street 1:11200 AVENUE 368
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93291-8940
Practice Address - Country:US
Practice Address - Phone:559-735-1360
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-19
Last Update Date:2009-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN209770164X00000X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No164X00000XNursing Service ProvidersLicensed Vocational Nurse