Provider Demographics
NPI:1518765676
Name:MELENDEZ CASTRO, CLARA ANAIS
Entity type:Individual
Prefix:
First Name:CLARA
Middle Name:ANAIS
Last Name:MELENDEZ CASTRO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2721 SE 10TH ST
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66607-1706
Mailing Address - Country:US
Mailing Address - Phone:785-783-8453
Mailing Address - Fax:785-783-8469
Practice Address - Street 1:2721 SE 10TH ST
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66607-1706
Practice Address - Country:US
Practice Address - Phone:785-783-8453
Practice Address - Fax:785-783-8469
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-05
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS250007172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker