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Individual

MR. GERARDO VIDAL CASTANEDA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1909 UNIVERSITY AVE, BERKELEY, CA 94704-1023
(510) 809-3004
(510) 809-3240
Mailing address
2215 SAN JOSE AVE APT B, ALAMEDA, CA 94501-4954
(510) 510-8385

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
172V00000X
Community Health Worker
225800000X
Recreation Therapist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0136
CA
Enumeration date
07/11/2007
Last updated
07/15/2025
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