Healthcare Provider Details

I. General information

NPI: 1407793862
Provider Name (Legal Business Name): VIVIANA HUERTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/02/2026
Last Update Date: 05/02/2026
Certification Date: 05/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23501 CINEMA DR STE 200
VALENCIA CA
91355-5430
US

IV. Provider business mailing address

23501 CINEMA DR STE 200
VALENCIA CA
91355-5430
US

V. Phone/Fax

Practice location:
  • Phone: 661-288-4800
  • Fax:
Mailing address:
  • Phone: 661-288-4800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberRN95191774
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: