Healthcare Provider Details

I. General information

NPI: 1285084848
Provider Name (Legal Business Name): MS. MARIA SELENE CASTORENA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MS. MARIA SELENE CASTORENA AYON

II. Dates (important events)

Enumeration Date: 06/15/2016
Last Update Date: 07/03/2025
Certification Date: 07/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13001 RAMONA BLVD STE I
IRWINDALE CA
91706-3752
US

IV. Provider business mailing address

13001 RAMONA BLVD STE I
IRWINDALE CA
91706-3752
US

V. Phone/Fax

Practice location:
  • Phone: 626-337-3828
  • Fax: 626-960-4163
Mailing address:
  • Phone: 626-337-3828
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberASW131017
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: