Active NPI
Jacqueline Castellon
- Counseling Psychologist
- Van Nuys, CA
National Provider Identifier
1306651591
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- 94025782
- Practice address
- 6454 Van Nuys Blvd Ste 111
Van Nuys, CA 91401-1445 - Phone
- (818) 336-6411
- NPI assigned
- Feb 12, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | 94025782 | CA | Primary |
Addresses
Primary practice location
6454 Van Nuys Blvd Ste 111
Van Nuys, CA 91401-1445
Mailing address
295 E Edgemont Dr
San Bernardino, CA 92404-2210
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 94025782 | CA | MD | Counseling Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1739318400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1739318400000",
"number": "1306651591",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "295 E EDGEMONT DR",
"city": "SAN BERNARDINO",
"state": "CA",
"postal_code": "924042210"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6454 VAN NUYS BLVD STE 111",
"city": "VAN NUYS",
"state": "CA",
"postal_code": "914011445",
"telephone_number": "818-336-6411"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CASTELLON",
"first_name": "JACQUELINE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-02-12",
"last_updated": "2025-02-12",
"certification_date": "2025-02-12",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychologist, Counseling",
"state": "CA",
"license": "94025782",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Van Nuys, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.