=====================================================
General NPI Number Information
=====================================================
NPI Number | 1841140621
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SAMANTHA CHRISTINA CASTELLANOS SLPA
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/30/2026
-----------------------------------------------------
Last Update Date | 01/30/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 632 W 11TH ST STE 119
-----------------------------------------------------
City | TRACY
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95376-3860
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 925-399-5796
-----------------------------------------------------
Fax | 209-362-4875
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 311 RAY ST
-----------------------------------------------------
City | PLEASANTON
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94566-6621
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 925-399-5796
-----------------------------------------------------
Fax | 209-362-4875
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2355S0801X
-----------------------------------------------------
Taxonomy Name | Speech-Language Assistant
-----------------------------------------------------
License Number | 10073
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------