Provider Demographics
NPI:1427791292
Name:CASTANEDA-ALCARAZ, MARIA
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:CASTANEDA-ALCARAZ
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 1:31764 CASINO DR
Mailing Address - Street 2:
Mailing Address - City:LAKE ELSINORE
Mailing Address - State:CA
Mailing Address - Zip Code:92530-2312
Mailing Address - Country:US
Mailing Address - Phone:951-203-3546
Mailing Address - Fax:
Practice Address - Street 1:31764 CASINO DR # 300
Practice Address - Street 2:
Practice Address - City:LAKE ELSINORE
Practice Address - State:CA
Practice Address - Zip Code:92530-2312
Practice Address - Country:US
Practice Address - Phone:951-436-7098
Practice Address - Fax:951-471-4687
Is Sole Proprietor?:No
Enumeration Date:2022-04-19
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No175T00000XOther Service ProvidersPeer Specialist
No172V00000XOther Service ProvidersCommunity Health Worker