Provider Demographics
NPI:1881354322
Name:CASTRO, DONNA (NP)
Entity type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:
Last Name:CASTRO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:438 FALLINGSTAR
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92614-7574
Mailing Address - Country:US
Mailing Address - Phone:949-668-3574
Mailing Address - Fax:
Practice Address - Street 1:438 FALLINGSTAR
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92614-7574
Practice Address - Country:US
Practice Address - Phone:949-668-3574
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-24
Last Update Date:2021-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95019570363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily