Provider Demographics
NPI:1881236511
Name:HERRERA CASTRO, RONALD ALEXANDER
Entity type:Individual
Prefix:
First Name:RONALD
Middle Name:ALEXANDER
Last Name:HERRERA CASTRO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14001 SUMMIT SIERRA BLVD UNIT 3236
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89511-9348
Mailing Address - Country:US
Mailing Address - Phone:775-354-4630
Mailing Address - Fax:
Practice Address - Street 1:14001 SUMMIT SIERRA BLVD UNIT 3236
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89511-9348
Practice Address - Country:US
Practice Address - Phone:775-354-4630
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-15
Last Update Date:2025-02-28
Deactivation Date:2024-05-02
Deactivation Code:
Reactivation Date:2024-06-28
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No374700000XNursing Service Related ProvidersTechnician
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider
No374U00000XNursing Service Related ProvidersHome Health Aide
No376J00000XNursing Service Related ProvidersHomemaker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVPCS7743Medicaid