Provider Demographics
NPI:1598285090
Name:DE CASTRO, CHRISTIAN LUMBERA (LVN)
Entity Type:Individual
Prefix:MR
First Name:CHRISTIAN
Middle Name:LUMBERA
Last Name:DE CASTRO
Suffix:
Gender:M
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23452 PACKER PL APT A
Mailing Address - Street 2:
Mailing Address - City:LAKE FOREST
Mailing Address - State:CA
Mailing Address - Zip Code:92630-4449
Mailing Address - Country:US
Mailing Address - Phone:949-510-1227
Mailing Address - Fax:
Practice Address - Street 1:23452 PACKER PL APT A
Practice Address - Street 2:
Practice Address - City:LAKE FOREST
Practice Address - State:CA
Practice Address - Zip Code:92630-4449
Practice Address - Country:US
Practice Address - Phone:949-510-1227
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-26
Last Update Date:2017-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA276523164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse