=====================================================
General NPI Number Information
=====================================================
NPI Number | 1114877990
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | WILLOW FAMILY THERAPY & WELLNESS INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/30/2026
-----------------------------------------------------
Last Update Date | 01/30/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3562 HOWARD AVE STE D
-----------------------------------------------------
City | LOS ALAMITOS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90720-3689
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 714-400-2897
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 16746 CAMPHOR ST
-----------------------------------------------------
City | FONTANA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92336-6610
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 714-400-2897
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/ THERAPIST
-----------------------------------------------------
Name | JOEY ESTELLA
-----------------------------------------------------
Credential | LMFT
-----------------------------------------------------
Telephone | 714-400-2897
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106H00000X
-----------------------------------------------------
Taxonomy Name | Marriage & Family Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------