Healthcare Provider Details

I. General information

NPI: 1518081942
Provider Name (Legal Business Name): ADRIANA WESTBY TRENT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/19/2007
Last Update Date: 07/28/2022
Certification Date: 07/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3325 PALO VERDE AVE STE 201
LONG BEACH CA
90808-4132
US

IV. Provider business mailing address

3325 PALO VERDE AVE STE 201
LONG BEACH CA
90808-4132
US

V. Phone/Fax

Practice location:
  • Phone: 562-542-3600
  • Fax:
Mailing address:
  • Phone: 562-542-3600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY25223
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: