Provider Demographics
NPI:1053365114
Name:CASTON, SAKESHA YOLONDA (OD)
Entity type:Individual
Prefix:DR
First Name:SAKESHA
Middle Name:YOLONDA
Last Name:CASTON
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2151 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29307-1421
Mailing Address - Country:US
Mailing Address - Phone:864-579-2015
Mailing Address - Fax:
Practice Address - Street 1:1268 EBENEZER RD
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-2341
Practice Address - Country:US
Practice Address - Phone:803-327-2001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-20
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1394152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYAA6619F642Medicare PIN