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NPI Code Detail

MEDICARE: MS. PATRICIA JEAN CASTANEDA NP-C

MEDICARE: MS. PATRICIA JEAN CASTANEDA NP-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerNP95013285CA

General Provider Information

NPI Number : 1619517166
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. PATRICIA JEAN CASTANEDA NP-C
Provider Business Mailing Address
First Line : 3988 JOHN VICKERS CT
Second Line :
City : EL CENTRO
State : CA
Zip : 92243-6718
Country : US
Telephone Number : 760-791-9662
Fax Number :
Provider Business Practice Location Address
First Line : 450 E BIRCH ST
Second Line :
City : CALEXICO
State : CA
Zip : 92231-2375
Country : US
Telephone Number : 760-768-6262
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/13/2020
Last Update Date : 01/13/2020

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