Individual provider Active NPI

Gerardo Vidal Castaneda

  • Case Manager/Care Coordinator
  • Berkeley, CA
National Provider Identifier
1134327166
Registry record updated Jul 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
1909 University Ave
Berkeley, CA 94704-1023
Phone
(510) 809-3004
Fax
(510) 809-3240
NPI assigned
Jul 11, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X
Mental Health Counselor 101YM0800X
Case Manager/Care Coordinator 171M00000X CA Primary
Recreation Therapist 225800000X

Addresses

Primary practice location

1909 University Ave
Berkeley, CA 94704-1023

Mailing address

2215 San Jose Ave Apt B
Alameda, CA 94501-4954
Phone (510) 510-8385

Other practice location 1

954 60th St
Suite 10
Oakland, CA 94608-2369
Phone (510) 835-2505

Other identifiers 1

IdentifierTypeStateIssuer
0136MedicaidCA

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bonita House, Inc. CurrentSince Jul 22, 2025 Accepting new patients
Bonita House, Inc. PastSince Jul 22, 2025 Accepting new patients
Mental Health Association of Alameda County Past Accepting new patients
Mental Health Association of Alameda County PastSince Jan 1, 2021 Accepting new patients

Locations

1909 University Ave
Berkeley, CA 94704
Phone (510) 809-3004

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1184112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785283200000",
    "number": "1134327166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2215 SAN JOSE AVE APT B",
            "city": "ALAMEDA",
            "state": "CA",
            "postal_code": "945014954",
            "telephone_number": "510-510-8385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1909 UNIVERSITY AVE",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947041023",
            "telephone_number": "510-809-3004",
            "fax_number": "510-809-3240"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "954 60th St",
            "address_2": "Suite 10",
            "address_purpose": "LOCATION",
            "city": "Oakland",
            "state": "CA",
            "postal_code": "946082369",
            "country_code": "US",
            "telephone_number": "510-835-2505",
            "fax_number": "510-835-1062",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VIDAL CASTANEDA",
        "first_name": "GERARDO",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-11",
        "last_updated": "2026-07-29",
        "certification_date": "2026-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "CA",
            "license": null,
            "primary": true
        },
        {
            "code": "225800000X",
            "taxonomy_group": "",
            "desc": "Recreation Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0136",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2026; 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.