MEDICARE: CYNTHIA CASTANEDA

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
1	106S00000X	Behavior Technician	F5729768	CA
2	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1669075164
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CYNTHIA CASTANEDA

Provider Business Mailing Address
First Line	:	4401 CRENSHAW BLVD STE 215
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90043-1200
Country	:	US
Telephone Number	:	323-291-7100
Fax Number	:

Provider Business Practice Location Address
First Line	:	4416 COMLY ST
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90063-1013
Country	:	US
Telephone Number	:	626-420-6500
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/17/2020
Last Update Date	:	01/18/2022

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Directions to “ CYNTHIA CASTANEDA ” Practice Location

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