Healthcare Provider Details

I. General information

NPI: 1043794118
Provider Name (Legal Business Name): VANESSA ANJELICA NAVARRO MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: VANESSA ANJELICA HUIZAR MS

II. Dates (important events)

Enumeration Date: 09/24/2018
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9500 HAVEN AVE STE 100
RANCHO CUCAMONGA CA
91730-5871
US

IV. Provider business mailing address

27261 LAS RAMBLAS STE 220
MISSION VIEJO CA
92691-6468
US

V. Phone/Fax

Practice location:
  • Phone: 909-980-6700
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberAPCC10065
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: