Provider Demographics
NPI:1104468321
Name:CASTRO-BARRETO, LAURA
Entity type:Individual
Prefix:MS
First Name:LAURA
Middle Name:
Last Name:CASTRO-BARRETO
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 1:8383 EUREKA ST
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93004-2146
Mailing Address - Country:US
Mailing Address - Phone:805-766-1021
Mailing Address - Fax:
Practice Address - Street 1:8383 EUREKA ST
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93004-2146
Practice Address - Country:US
Practice Address - Phone:805-766-1021
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-09
Last Update Date:2019-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106S00000X
106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician