Doctor Name: | MR. CHARLES ALFONZO CASTOR-THOMAS |
NPI Number: | 1003074899 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | |
Business Practice Address: | 2221 Enborg Ln San Jose, CA - 951282608 |
Business Phone Number: | 4088853227 |
Business Fax Number: | 4088852063 |
Mailing Address: | 2221 Enborg Ln, SAN JOSE |
State: | CA |
Postal Code: | 951282608 |
Phone Number: | 4088853227 |
Fax Number: | 4088852063 |
NPI Enumeration Date: | 05/28/2008 |
NPI Last Update Date: | 05/28/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |