Provider Demographics
NPI:1801120407
Name:CASTANEDA, CHRISTIAN (MSW)
Entity type:Individual
Prefix:MR
First Name:CHRISTIAN
Middle Name:
Last Name:CASTANEDA
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:535 MAGNOLIA AVE UNIT 415
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90802-6639
Mailing Address - Country:US
Mailing Address - Phone:562-208-7216
Mailing Address - Fax:
Practice Address - Street 1:1157 LEMOYNE ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90026-3206
Practice Address - Country:US
Practice Address - Phone:213-483-6335
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-29
Last Update Date:2011-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical