Healthcare Provider Details

I. General information

NPI: 1578329348
Provider Name (Legal Business Name): MADELINE GONZALEZ CASTANEDA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/28/2024
Last Update Date: 03/18/2025
Certification Date: 03/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14545 SHERMAN CIR
VAN NUYS CA
91405-3087
US

IV. Provider business mailing address

146 N HUNTINGTON ST
SAN FERNANDO CA
91340-2614
US

V. Phone/Fax

Practice location:
  • Phone: 818-908-4999
  • Fax:
Mailing address:
  • Phone: 818-855-4906
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberAMFT15322
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: