Provider Demographics
NPI:1700044807
Name:CASTELO, MELJORIE (REGISTERED NURSE)
Entity Type:Individual
Prefix:MRS
First Name:MELJORIE
Middle Name:
Last Name:CASTELO
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3047 TIFFANY LN
Mailing Address - Street 2:
Mailing Address - City:COLTON
Mailing Address - State:CA
Mailing Address - Zip Code:92324-9215
Mailing Address - Country:US
Mailing Address - Phone:909-213-6860
Mailing Address - Fax:909-307-9692
Practice Address - Street 1:3047 TIFFANY LN
Practice Address - Street 2:
Practice Address - City:COLTON
Practice Address - State:CA
Practice Address - Zip Code:92324-9215
Practice Address - Country:US
Practice Address - Phone:909-213-6860
Practice Address - Fax:909-307-9692
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-27
Last Update Date:2008-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA420619163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse