Healthcare Provider Details

I. General information

NPI: 1386104230
Provider Name (Legal Business Name): GEMA CASTELLON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/25/2019
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27186 NEWPORT RD STE D4
MENIFEE CA
92584-7386
US

IV. Provider business mailing address

34016 WALNUT CREEK RD.
WIDOMAR CA
92595
US

V. Phone/Fax

Practice location:
  • Phone: 951-800-3211
  • Fax:
Mailing address:
  • Phone: 951-746-4578
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number712141
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number95030915
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95030915
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: