Provider Demographics
NPI:1528377504
Name:GASTELUM, CLAUDIA MINERVA (ASW)
Entity Type:Individual
Prefix:MS
First Name:CLAUDIA
Middle Name:MINERVA
Last Name:GASTELUM
Suffix:
Gender:F
Credentials:ASW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 S. BEAUDRY AVENUE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90017
Mailing Address - Country:US
Mailing Address - Phone:213-241-3841
Mailing Address - Fax:213-241-3305
Practice Address - Street 1:333 S. BEAUDRY AVENUE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90017
Practice Address - Country:US
Practice Address - Phone:213-241-3841
Practice Address - Fax:213-241-3305
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-24
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW31568101YM0800X
CA859591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health