| Doctor Name: | NICOLE CASELLA |
| NPI Number: | 1174925747 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 63993 |
| Business Practice Address: | 341 Hillcrest St La Habra, CA - 906315340 |
| Business Phone Number: | 5626913263 |
| Business Fax Number: | |
| Mailing Address: | 24455 Paseo De Toronto, YORBA LINDA |
| State: | CA |
| Postal Code: | 928874939 |
| Phone Number: | 7148014428 |
| Fax Number: | |
| NPI Enumeration Date: | 09/25/2014 |
| NPI Last Update Date: | 09/25/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 251V00000X |
| License Number: | 63993 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | Voluntary or Charitable |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |