Healthcare Provider Details

I. General information

NPI: 1235598384
Provider Name (Legal Business Name): ESTELLA M CASTANEDES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/17/2016
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1774 ZONAL AVE BLDG B
LOS ANGELES CA
90033-1064
US

IV. Provider business mailing address

1774 ZONAL AVE BLDG B
LOS ANGELES CA
90033-1064
US

V. Phone/Fax

Practice location:
  • Phone: 310-221-6336
  • Fax:
Mailing address:
  • Phone: 310-221-6336
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code374700000X
TaxonomyTechnician
License Number00022998
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License Number255299
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: