Healthcare Provider Details

I. General information

NPI: 1790611663
Provider Name (Legal Business Name): WELL BALANCED PSYCHIATRY AND BEHAVIORAL HEALTH, A PROFESSIONAL NURSING CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

517 S IVY AVE
MONROVIA CA
91016-2827
US

IV. Provider business mailing address

517 S IVY AVE
MONROVIA CA
91016-2827
US

V. Phone/Fax

Practice location:
  • Phone: 315-547-0502
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: LEAH TRELLA
Title or Position: OWNER
Credential:
Phone: 315-547-0502