Provider Demographics
NPI:1417384660
Name:CASTELLANOS, BIANCA C
Entity Type:Individual
Prefix:
First Name:BIANCA
Middle Name:C
Last Name:CASTELLANOS
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 1:500 S MAIN ST STE 1100
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-4513
Mailing Address - Country:US
Mailing Address - Phone:714-543-4333
Mailing Address - Fax:714-543-4398
Practice Address - Street 1:500 S MAIN ST STE 1100
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-4513
Practice Address - Country:US
Practice Address - Phone:714-543-4333
Practice Address - Fax:714-543-4398
Is Sole Proprietor?:No
Enumeration Date:2013-10-02
Last Update Date:2013-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator