Provider Demographics
NPI:1467831289
Name:CASTORENA, MELINDA (COUNSELOR)
Entity Type:Individual
Prefix:
First Name:MELINDA
Middle Name:
Last Name:CASTORENA
Suffix:
Gender:F
Credentials:COUNSELOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1424
Mailing Address - Street 2:
Mailing Address - City:UKIAH
Mailing Address - State:CA
Mailing Address - Zip Code:95482-1424
Mailing Address - Country:US
Mailing Address - Phone:707-463-0405
Mailing Address - Fax:707-463-0405
Practice Address - Street 1:270 N PINE ST
Practice Address - Street 2:
Practice Address - City:UKIAH
Practice Address - State:CA
Practice Address - Zip Code:95482-4334
Practice Address - Country:US
Practice Address - Phone:707-463-0405
Practice Address - Fax:707-463-0405
Is Sole Proprietor?:No
Enumeration Date:2015-05-26
Last Update Date:2015-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor