Provider Demographics
NPI:1659546471
Name:CASTANEDA BUGARIN, LUIS MIGUEL (BS)
Entity Type:Individual
Prefix:
First Name:LUIS
Middle Name:MIGUEL
Last Name:CASTANEDA BUGARIN
Suffix:
Gender:M
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:83 E SHAW AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710
Mailing Address - Country:US
Mailing Address - Phone:559-439-5437
Mailing Address - Fax:559-226-2837
Practice Address - Street 1:83 E SHAW AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-7620
Practice Address - Country:US
Practice Address - Phone:559-439-5437
Practice Address - Fax:559-226-2837
Is Sole Proprietor?:No
Enumeration Date:2008-04-23
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor