Provider Demographics
NPI:1710769096
Name:CASTEEL, JANICE LOUISE (LEP)
Entity Type:Individual
Prefix:MRS
First Name:JANICE
Middle Name:LOUISE
Last Name:CASTEEL
Suffix:
Gender:F
Credentials:LEP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33601 PORT MARINE DR
Mailing Address - Street 2:
Mailing Address - City:DANA POINT
Mailing Address - State:CA
Mailing Address - Zip Code:92629-2149
Mailing Address - Country:US
Mailing Address - Phone:714-287-1042
Mailing Address - Fax:949-429-1823
Practice Address - Street 1:3900 BIRCH ST
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-2209
Practice Address - Country:US
Practice Address - Phone:714-287-1042
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-20
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALEP1850103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool