Healthcare Provider Details

I. General information

NPI: 1427612399
Provider Name (Legal Business Name): GUADALUPE CASTANEDA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2019
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date: 07/24/2026
Reactivation Date: 08/26/2026

III. Provider practice location address

39000 BOB HOPE DR
RANCHO MIRAGE CA
92270-3202
US

IV. Provider business mailing address

39000 BOB HOPE DR
RANCHO MIRAGE CA
92270-3202
US

V. Phone/Fax

Practice location:
  • Phone: 760-773-2882
  • Fax: 760-773-2680
Mailing address:
  • Phone: 760-773-2882
  • Fax: 760-773-2680

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number95040673
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: