Healthcare Provider Details

I. General information

NPI: 1518766278
Provider Name (Legal Business Name): NUNA MENTAL WELLNESS, PSYCHIATRIC MENTAL HEALTH NURSING, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2025
Last Update Date: 03/13/2025
Certification Date: 03/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19387 CASCADE DR
TRABUCO CANYON CA
92679
US

IV. Provider business mailing address

26741 PORTOLA PARKWAY STE. 1E #659
FOOTHILL RANCH CA
92610-1763
US

V. Phone/Fax

Practice location:
  • Phone: 949-994-6468
  • Fax:
Mailing address:
  • Phone: 949-994-6468
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: GABRIELA URSULA VILLAFUERTE
Title or Position: PRESIDENT
Credential: FNP-BC, PMHNP-BC
Phone: 949-994-6468