Provider Demographics
NPI:1740086446
Name:CASTANEDA, ADELA (MOT, OTR/L)
Entity type:Individual
Prefix:
First Name:ADELA
Middle Name:
Last Name:CASTANEDA
Suffix:
Gender:
Credentials:MOT, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3530 PAN AMERICAN FWY NE STE D
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87107-4793
Mailing Address - Country:US
Mailing Address - Phone:505-888-4469
Mailing Address - Fax:
Practice Address - Street 1:3530 PAN AMERICAN FWY NE STE D
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87107-4793
Practice Address - Country:US
Practice Address - Phone:505-888-4469
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-22
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMOT-2025-0031225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist