Healthcare Provider Details

I. General information

NPI: 1457278707
Provider Name (Legal Business Name): ASHLEY JANELL GASTELUM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24355 LYONS AVE
NEWHALL CA
91321-2300
US

IV. Provider business mailing address

43547 CARPENTER DR
LANCASTER CA
93535-4884
US

V. Phone/Fax

Practice location:
  • Phone: 661-254-7086
  • Fax: 661-254-7108
Mailing address:
  • Phone: 818-220-0795
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: