Provider Demographics
NPI:1770590465
Name:CASTRO, JULIE ELIZABETH (NP)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:ELIZABETH
Last Name:CASTRO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:ELIZABETH
Other - Last Name:FRIEND
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:6177 BLOSSOM AVE
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95123-4650
Mailing Address - Country:US
Mailing Address - Phone:408-807-7290
Mailing Address - Fax:
Practice Address - Street 1:1149 E JULIAN ST
Practice Address - Street 2:BLDG H
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95116-1005
Practice Address - Country:US
Practice Address - Phone:408-535-6001
Practice Address - Fax:408-535-2348
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA518911163W00000X
CANP13699363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse