Provider Demographics
NPI:1285084848
Name:CASTORENA, MARIA SELENE
Entity type:Individual
Prefix:MS
First Name:MARIA
Middle Name:SELENE
Last Name:CASTORENA
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:MARIA
Other - Middle Name:SELENE
Other - Last Name:CASTORENA AYON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:800 S. SANTA ANITA AVE.
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91006
Mailing Address - Country:US
Mailing Address - Phone:626-254-5000
Mailing Address - Fax:626-294-1079
Practice Address - Street 1:13001 RAMONA BLVD
Practice Address - Street 2:STE I
Practice Address - City:IRWINDALE
Practice Address - State:CA
Practice Address - Zip Code:91706-3752
Practice Address - Country:US
Practice Address - Phone:626-337-3828
Practice Address - Fax:626-960-4163
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-15
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator