Provider Demographics
NPI:1225834187
Name:CASTELLANOS, ASHLEY DIANNE
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:DIANNE
Last Name:CASTELLANOS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1323 TALMADGE ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90027-1530
Mailing Address - Country:US
Mailing Address - Phone:213-783-0090
Mailing Address - Fax:
Practice Address - Street 1:1150 S OLIVE ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90015-2211
Practice Address - Country:US
Practice Address - Phone:213-783-0090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-21
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker