Healthcare Provider Details

I. General information

NPI: 1578486932
Provider Name (Legal Business Name): ASMARA BEHAVIORAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1968 S COAST HWY # 2862
LAGUNA BEACH CA
92651-3681
US

IV. Provider business mailing address

7032 MALVERN AVE
RANCHO CUCAMONGA CA
91701-6013
US

V. Phone/Fax

Practice location:
  • Phone: 562-444-2853
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name: MS. SAVANNAH LEE BOWMAN VILLAFANA I
Title or Position: BEHAVIORAL THERAPIST
Credential:
Phone: 909-532-0768