Healthcare Provider Details

I. General information

NPI: 1811821531
Provider Name (Legal Business Name): HENAI CASTANEDA LPN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1021 E PALMDALE ST STE 130
TUCSON AZ
85714-1859
US

IV. Provider business mailing address

PO BOX 86537
TUCSON AZ
85754-6537
US

V. Phone/Fax

Practice location:
  • Phone: 520-407-5353
  • Fax: 520-372-7370
Mailing address:
  • Phone: 520-721-1887
  • Fax: 520-721-0069

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberLP051985
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: