Provider Demographics
NPI:1063748069
Name:CASELIN, LETICIA ESMERALDA
Entity type:Individual
Prefix:MISS
First Name:LETICIA
Middle Name:ESMERALDA
Last Name:CASELIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3580 WILSHIRE BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90010-2501
Mailing Address - Country:US
Mailing Address - Phone:213-637-5000
Mailing Address - Fax:
Practice Address - Street 1:3580 WILSHIRE BLVD FL 8
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90010-2505
Practice Address - Country:US
Practice Address - Phone:213-637-5000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-26
Last Update Date:2010-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator