Provider Demographics
NPI:1205385010
Name:CASTELLANO, JANNET DELA CRUZ
Entity type:Individual
Prefix:MRS
First Name:JANNET
Middle Name:DELA CRUZ
Last Name:CASTELLANO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:62 CIVIC CENTER PLZ
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92701-4060
Mailing Address - Country:US
Mailing Address - Phone:714-245-8117
Mailing Address - Fax:714-245-8267
Practice Address - Street 1:62 CIVIC CENTER PLZ
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92701-4060
Practice Address - Country:US
Practice Address - Phone:714-245-8117
Practice Address - Fax:714-245-8267
Is Sole Proprietor?:No
Enumeration Date:2016-09-22
Last Update Date:2016-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95030547163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse