Provider Demographics
NPI:1518648567
Name:ORELLANA DE CASTANEDA, MONICA M
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:M
Last Name:ORELLANA DE CASTANEDA
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 1:2039 POMONA AVE
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92627-2948
Mailing Address - Country:US
Mailing Address - Phone:818-923-0440
Mailing Address - Fax:
Practice Address - Street 1:2039 POMONA AVE
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92627-2948
Practice Address - Country:US
Practice Address - Phone:818-923-0440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-31
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty