Jacqueline G de Castro MD Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A101754 Issued in CA

Legal business name

JACQUELINE G DE CASTRO MD INC

Practice address

460 Greenfield Ave
Suite 4
Hanford, CA 93230-3500

Phone

(559) 582-9100

Fax

(559) 582-9103

NPI assigned

Jul 1, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Jacqueline G Decastro, M.D.NPI 1124241559

Title

Ceo

Phone

(559) 583-4510

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jacqueline Gaerlan De Castro, MD

  • Family Medicine Physician
  • Hanford, CA
  • NPI 1124241559

  CA, Family Medicine

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1214870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1255593299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2117",
            "city": "HANFORD",
            "state": "CA",
            "postal_code": "932322117",
            "telephone_number": "559-582-9100",
            "fax_number": "559-582-9103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 GREENFIELD AVE",
            "address_2": "SUITE 4",
            "city": "HANFORD",
            "state": "CA",
            "postal_code": "932303500",
            "telephone_number": "559-582-9100",
            "fax_number": "559-582-9103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACQUELINE G DE CASTRO MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-01",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "DECASTRO",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "559-583-4510",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A101754",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ECFMG",
            "identifier": "0-649-8026",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Andrea Delois Jackson, FNP
• Joytonia Jackson, DOULA
• Ibris Guadalupe Jaimes
• Zainab Jalloh
• James Carter Thomas MD Apc
• James E Dean M D P C
• James N. Eustermann, M.D., Inc.

• All providers in Hanford, CA
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.