Healthcare Provider Details

I. General information

NPI: 1457016818
Provider Name (Legal Business Name): GABRIELA CASTANEDA PSY.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2021
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3625 RUFFIN RD
SAN DIEGO CA
92123-1879
US

IV. Provider business mailing address

2901 MEADOW LARK DR
SAN DIEGO CA
92123-2711
US

V. Phone/Fax

Practice location:
  • Phone: 619-694-4600
  • Fax:
Mailing address:
  • Phone: 619-694-4600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number35999
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: