Provider Demographics
NPI:1104470954
Name:CASTANEDA, VALERIE ISABEL
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:ISABEL
Last Name:CASTANEDA
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 1:784 E HOWARD ST
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91104-2349
Mailing Address - Country:US
Mailing Address - Phone:626-372-3384
Mailing Address - Fax:
Practice Address - Street 1:5435 BALBOA BLVD
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91316-1508
Practice Address - Country:US
Practice Address - Phone:310-933-4499
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-30
Last Update Date:2019-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst