Healthcare Provider Details

I. General information

NPI: 1992612535
Provider Name (Legal Business Name): KAELYN VILLAMIL CRUZ BSN, RN, PHN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KAELYN CRUZ BSN, RN, PHN

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8324 WESTMAN AVE
WHITTIER CA
90606-3314
US

IV. Provider business mailing address

3400 CASTLEFORD PL
ROWLAND HEIGHTS CA
91748-5108
US

V. Phone/Fax

Practice location:
  • Phone: 562-692-0271
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN95435574
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: