Healthcare Provider Details

I. General information

NPI: 1831029206
Provider Name (Legal Business Name): CLIBERN DIZON VILLAFLOR MSN, PMHNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18800 AMAR RD STE B16
WALNUT CA
91789-7101
US

IV. Provider business mailing address

10808 FOOTHILL BLVD STE 160-419
RANCHO CUCAMONGA CA
91730-3889
US

V. Phone/Fax

Practice location:
  • Phone: 626-332-0311
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95039374
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: