Provider Demographics
NPI:1457780876
Name:CASTLEMAN, HEATHER (DC)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:CASTLEMAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33733 YUCAIPA BLVD STE 7
Mailing Address - Street 2:
Mailing Address - City:YUCAIPA
Mailing Address - State:CA
Mailing Address - Zip Code:92399-2256
Mailing Address - Country:US
Mailing Address - Phone:909-797-1705
Mailing Address - Fax:909-797-6262
Practice Address - Street 1:33733 YUCAIPA BLVD STE 7
Practice Address - Street 2:
Practice Address - City:YUCAIPA
Practice Address - State:CA
Practice Address - Zip Code:92399-2256
Practice Address - Country:US
Practice Address - Phone:909-797-1705
Practice Address - Fax:909-797-6262
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-06
Last Update Date:2013-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC19728111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor