Healthcare Provider Details

I. General information

NPI: 1184927741
Provider Name (Legal Business Name): YESENIA CASTELLON N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/20/2010
Last Update Date: 01/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44900 60TH ST W
LANCASTER CA
93536-7618
US

IV. Provider business mailing address

38401 ANTIBES DR
PALMDALE CA
93552-3342
US

V. Phone/Fax

Practice location:
  • Phone: 661-948-8581
  • Fax: 661-945-8304
Mailing address:
  • Phone: 818-324-9765
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number606557
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number606557
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: