Provider Demographics
NPI:1760669915
Name:CASTRO, JAVIER JR
Entity Type:Individual
Prefix:
First Name:JAVIER
Middle Name:
Last Name:CASTRO
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2220 WATT AVE STE B
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-0505
Mailing Address - Country:US
Mailing Address - Phone:916-485-6814
Mailing Address - Fax:
Practice Address - Street 1:2220 WATT AVE STE B
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-0505
Practice Address - Country:US
Practice Address - Phone:916-393-1222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-29
Last Update Date:2010-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health