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NPI 1689277337

NPI 1689277337 : MR. CHRISTIAN JOSE CASTELLON : SAN JOSE, CA

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General NPI Number Information
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    NPI Number           |    1689277337
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    Entity Type          |    Individual 
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    Provider Name        |    MR. CHRISTIAN JOSE CASTELLON
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    11/17/2020
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    Last Update Date     |    07/02/2025
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Provider Practice Location Address
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    Address Line         |    425 E SANTA CLARA ST 
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    City                 |    SAN JOSE
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    State                |    CA
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    Zip                  |    95113-1936
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    Country              |    US
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    Telephone            |    408-318-1286
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    9015 MURRAY AVE 
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    City                 |    GILROY
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    State                |    CA
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    Zip                  |    95020-3673
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    Country              |    US
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    Telephone            |    408-842-7138
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    171M00000X
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    Taxonomy Name        |    Case Manager/Care Coordinator
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    License Number       |    278800584
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    License Number State |    NY
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Taxonomy #2
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    Taxonomy Code        |    225400000X
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    Taxonomy Name        |    Rehabilitation Practitioner
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    License Number       |    
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    License Number State |    
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