Provider Demographics
NPI:1669781498
Name:CASTANEDA-HOGAN, EVA (MACP/MFT)
Entity type:Individual
Prefix:MRS
First Name:EVA
Middle Name:
Last Name:CASTANEDA-HOGAN
Suffix:
Gender:F
Credentials:MACP/MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2764 COTTONWOOD TRL
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91761-7439
Mailing Address - Country:US
Mailing Address - Phone:909-724-8247
Mailing Address - Fax:
Practice Address - Street 1:2285 CARROTWOOD DR
Practice Address - Street 2:
Practice Address - City:BREA
Practice Address - State:CA
Practice Address - Zip Code:92821-4681
Practice Address - Country:US
Practice Address - Phone:909-724-8247
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-28
Last Update Date:2019-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106H00000X
CA106549106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist