Provider Demographics
NPI:1124241559
Name:DE CASTRO, JACQUELINE GAERLAN (MD)
Entity type:Individual
Prefix:DR
First Name:JACQUELINE
Middle Name:GAERLAN
Last Name:DE CASTRO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 2117
Mailing Address - Street 2:
Mailing Address - City:HANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:93232-2117
Mailing Address - Country:US
Mailing Address - Phone:559-582-9100
Mailing Address - Fax:559-582-9103
Practice Address - Street 1:1457 BAILEY ST
Practice Address - Street 2:
Practice Address - City:HANFORD
Practice Address - State:CA
Practice Address - Zip Code:93230-5943
Practice Address - Country:US
Practice Address - Phone:559-582-9100
Practice Address - Fax:559-582-9103
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2020-04-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA101754207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine