MEDICARE: STEPHANIE CASTANON

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	1041C0700X	Clinical Social Worker	100233	CA

General Provider Information

NPI Number	:	1730557273
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE CASTANON

Provider Business Mailing Address
First Line	:	2055 N PERRIS BLVD STE C
Second Line	:
City	:	PERRIS
State	:	CA
Zip	:	92571-2509
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2055 N PERRIS BLVD STE C
Second Line	:
City	:	PERRIS
State	:	CA
Zip	:	92571-2509
Country	:	US
Telephone Number	:	951-715-5050
Fax Number	:

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

Provider Enumeration Date	:	09/14/2015
Last Update Date	:	03/12/2026

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Directions to “ STEPHANIE CASTANON ” Practice Location

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