Provider Demographics
NPI:1215134028
Name:CASTANEDA, REBECCA (DDS)
Entity type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:
Last Name:CASTANEDA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 SUTTER ST
Mailing Address - Street 2:STE 1616
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94108-4206
Mailing Address - Country:US
Mailing Address - Phone:415-986-1616
Mailing Address - Fax:415-986-1776
Practice Address - Street 1:450 SUTTER ST
Practice Address - Street 2:STE 1616
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94108-4206
Practice Address - Country:US
Practice Address - Phone:415-986-1616
Practice Address - Fax:415-986-1776
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA352021223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics