Healthcare Provider Details

I. General information

NPI: 1376014068
Provider Name (Legal Business Name): RHIANA LEIGH VILLASENOR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/06/2018
Last Update Date: 10/09/2025
Certification Date: 10/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13200 CROSSROADS PKWY N BLDG 300
CITY OF INDUSTRY CA
91746-3459
US

IV. Provider business mailing address

13200 CROSSROADS PKWY N BLDG 300
CITY OF INDUSTRY CA
91746-3459
US

V. Phone/Fax

Practice location:
  • Phone: 562-821-1491
  • Fax:
Mailing address:
  • Phone: 562-821-1491
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TA0700X
TaxonomyAdult Development & Aging Psychologist
License Number94029226
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: