Provider Demographics
NPI:1184927741
Name:CASTELLON, YESENIA (NP)
Entity type:Individual
Prefix:MRS
First Name:YESENIA
Middle Name:
Last Name:CASTELLON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38401 ANTIBES DR
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93552-3342
Mailing Address - Country:US
Mailing Address - Phone:818-324-9765
Mailing Address - Fax:
Practice Address - Street 1:44900 60TH ST W
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93536-7618
Practice Address - Country:US
Practice Address - Phone:661-948-8581
Practice Address - Fax:661-945-8304
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-20
Last Update Date:2014-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA606557363LA2100X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care