Individual provider Active NPI

Jobbie De Castro, RN

  • Registered Nurse
  • San Diego, CA
National Provider Identifier
1104309293
Registry record updated Sep 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
699266 Issued in CA
Practice address
3940 Hancock St Ste 104
San Diego, CA 92110-5158
Phone
(844) 644-4325
NPI assigned
Sep 13, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 699266 CA Primary

Addresses

Primary practice location

3940 Hancock St Ste 104
San Diego, CA 92110-5158

Mailing address

9115 Judicial Dr Apt 4139
San Diego, CA 92122-4619
Phone (808) 227-1455

Other identifiers 1

IdentifierTypeStateIssuer
699266OtherCABOARD OF REGISTERED NURSES

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
699266CAMDRegistered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1536796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536796800000",
    "number": "1104309293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9115 JUDICIAL DR APT 4139",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921224619",
            "telephone_number": "808-227-1455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3940 HANCOCK ST STE 104",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921105158",
            "telephone_number": "844-644-4325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE CASTRO",
        "first_name": "JOBBIE",
        "name_prefix": "Ms.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-13",
        "last_updated": "2018-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "699266",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF REGISTERED NURSES",
            "identifier": "699266",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.