Individual
MRS. EVA CASTELLANOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
12141 BROOKHURST ST, GARDEN GROVE, CA 92840-2865
(714) 296-1943
Mailing address
11672 MOEN ST, ANAHEIM, CA 92804-6734
(714) 809-7492
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
VN727335
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D2767102
DRIVER'S LICENSE
CA
Enumeration date
11/01/2022
Last updated
12/07/2022
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