Provider Demographics
NPI:1548473341
Name:CASTLE, GEORGINA ELIZABETH (DACM LAC)
Entity type:Individual
Prefix:DR
First Name:GEORGINA
Middle Name:ELIZABETH
Last Name:CASTLE
Suffix:
Gender:F
Credentials:DACM LAC
Other - Prefix:
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Mailing Address - Street 1:46 W JORDAN AVE
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93611-7185
Mailing Address - Country:US
Mailing Address - Phone:707-299-0767
Mailing Address - Fax:559-532-0209
Practice Address - Street 1:7638 N INGRAM AVE #102
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93711
Practice Address - Country:US
Practice Address - Phone:559-325-4775
Practice Address - Fax:559-532-0209
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA10235171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist