Provider Demographics
NPI:1013702133
Name:CASTELLON, DIANA J (CHW)
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:J
Last Name:CASTELLON
Suffix:
Gender:
Credentials:CHW
Other - Prefix:
Other - First Name:DIANA
Other - Middle Name:J
Other - Last Name:CASTELLON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CHW
Mailing Address - Street 1:2125 CENTERPOINTE PKWY STE 302
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93455-1337
Mailing Address - Country:US
Mailing Address - Phone:805-714-4292
Mailing Address - Fax:
Practice Address - Street 1:2125 CENTERPOINTE PKWY STE 302
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93455-1337
Practice Address - Country:US
Practice Address - Phone:805-714-4292
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-10
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker