Provider Demographics
NPI:1063174217
Name:CASTANEDA, CHRISTINE (LCSW-S)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:CASTANEDA
Suffix:
Gender:F
Credentials:LCSW-S
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:CASTANEDA
Other - Last Name:SOLIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW-S
Mailing Address - Street 1:201 SAN ANTONIO AVE
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78201-5313
Mailing Address - Country:US
Mailing Address - Phone:210-857-4980
Mailing Address - Fax:
Practice Address - Street 1:201 SAN ANTONIO AVE
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78201-5313
Practice Address - Country:US
Practice Address - Phone:210-857-4980
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-05
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX566561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical