Healthcare Provider Details

I. General information

NPI: 1477251924
Provider Name (Legal Business Name): TENYA MAI THURSTON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2023
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28494 WESTINGHOUSE PL STE 111
VALENCIA CA
91355-0931
US

IV. Provider business mailing address

28494 WESTINGHOUSE PL STE 111
VALENCIA CA
91355-0931
US

V. Phone/Fax

Practice location:
  • Phone: 661-429-0518
  • Fax:
Mailing address:
  • Phone: 661-903-8822
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT163833
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: