Healthcare Provider Details

I. General information

NPI: 1174932024
Provider Name (Legal Business Name): CINDY CASTELAZO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CINDY GARCIA

II. Dates (important events)

Enumeration Date: 08/05/2014
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 E CHESTNUT AVE
SANTA ANA CA
92701-6322
US

IV. Provider business mailing address

24982 EXPRESS DR
LAGUNA HILLS CA
92653-5115
US

V. Phone/Fax

Practice location:
  • Phone: 714-558-5501
  • Fax:
Mailing address:
  • Phone: 949-232-4068
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number21389
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: