Provider Demographics
NPI:1093511099
Name:CASTANEDA, CHINA VONDALE (RN)
Entity type:Individual
Prefix:
First Name:CHINA
Middle Name:VONDALE
Last Name:CASTANEDA
Suffix:
Gender:
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3800 S DECATUR BLVD SPC 170
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89103-5823
Mailing Address - Country:US
Mailing Address - Phone:702-688-2418
Mailing Address - Fax:
Practice Address - Street 1:3800 S DECATUR BLVD SPC 170
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89103-5823
Practice Address - Country:US
Practice Address - Phone:702-688-2418
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-20
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV842121163WP0808X
WARN61328581163WP0808X
CA95303123163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health