Provider Demographics
NPI:1174158240
Name:CASTRO, BERNIE H SR
Entity type:Individual
Prefix:
First Name:BERNIE
Middle Name:H
Last Name:CASTRO
Suffix:SR
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 1:1213 S CLAREMONT ST
Mailing Address - Street 2:
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94402-2114
Mailing Address - Country:US
Mailing Address - Phone:650-689-5597
Mailing Address - Fax:650-689-5697
Practice Address - Street 1:826 MAHLER RD
Practice Address - Street 2:
Practice Address - City:BURLINGAME
Practice Address - State:CA
Practice Address - Zip Code:94010-1604
Practice Address - Country:US
Practice Address - Phone:650-689-9559
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-09
Last Update Date:2020-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor