Individual
JEANNEATHE CASTELLANOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
120 S STATE COLLEGE BLVD, BREA, CA 92821-5834
(714) 577-5400
(714) 577-5450
Mailing address
120 S STATE COLLEGE BLVD STE 150, BREA, CA 92821-5837
(714) 577-5400
(714) 577-5450
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
952633765
MEDI-CAL
CA
Enumeration date
06/26/2007
Last updated
08/22/2024
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