Individual provider Active NPI

Carol Anne Castillo, MD

  • Family Medicine Physician
  • Sonoma, CA
National Provider Identifier
1104878909
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G077909 Issued in CA
Practice address
15000 Arnold Drive
Sonoma, CA 95431-1493
Phone
(707) 938-6556
NPI assigned
May 17, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X G077909 CA Primary

Addresses

Primary practice location

15000 Arnold Drive
Sonoma, CA 95431-1493

Mailing address

1600 9TH Street
Room 205 Mailstop 2-3
Sacramento, CA 95814-6414
Phone (916) 654-2431

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090728000259 CA Practitioner - Family Practice 8820141690 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G077909CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
State of California - Department of Developmental Services Current Accepting new patients
Agnews Community Clinic CurrentSince May 23, 2007 Accepting new patients
State of California - Department of Developmental Services CurrentSince May 23, 2007 Accepting new patients
State of California - Department of Developmental Services Past Accepting new patients

Locations

15000 Arnold Dr
Eldridge, CA 95431
Phone (707) 938-6000

3530 Pomona Blvd
Pomona, CA 91768
Phone (909) 444-7200

26501 Avenue 140
Porterville, CA 93257
Phone (559) 782-2222

Interoperability endpoints

  • Direct secure messaging: ccastillo678070@direct.ochin.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104878909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 9TH STREET",
            "address_2": "ROOM 205 MAILSTOP 2-3",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958146414",
            "telephone_number": "916-654-2431",
            "fax_number": "916-654-3186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15000 ARNOLD DRIVE",
            "city": "SONOMA",
            "state": "CA",
            "postal_code": "954311493",
            "telephone_number": "707-938-6556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASTILLO",
        "first_name": "CAROL",
        "middle_name": "ANNE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G077909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sonoma, CA

Sources for this page

Verify at the official NPI Registry.