Provider Demographics
NPI:1750019824
Name:DE CASTRO, SHARLENE JOYCE SISON
Entity type:Individual
Prefix:
First Name:SHARLENE JOYCE
Middle Name:SISON
Last Name:DE 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 1:2101 GRANGER AVE # 101-A
Mailing Address - Street 2:
Mailing Address - City:NATIONAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91950-6208
Mailing Address - Country:US
Mailing Address - Phone:844-200-2426
Mailing Address - Fax:
Practice Address - Street 1:2101 GRANGER AVE # 101-A
Practice Address - Street 2:
Practice Address - City:NATIONAL CITY
Practice Address - State:CA
Practice Address - Zip Code:91950-6208
Practice Address - Country:US
Practice Address - Phone:844-200-2426
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-08
Last Update Date:2023-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP95021762363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily