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General NPI Number Information
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NPI Number | 1215800669
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Entity Type | Organization
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Legal Business Name | CA PSYCHIATRY & MENTAL HEALTH NURSING PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 09/23/2025
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Last Update Date | 11/05/2025
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Provider Practice Location Address
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Address Line | 540 W RANCHO VISTA BLVD STE 102
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City | PALMDALE
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State | CA
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Zip | 93551-3010
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Country | US
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Telephone | 661-339-4306
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Fax |
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Provider Business Mailing Address
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Address Line | 540 W RANCHO VISTA BLVD STE 102
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City | PALMDALE
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State | CA
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Zip | 93551-3010
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Country | US
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Telephone | 661-231-6422
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Fax | 661-231-6595
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Authorized Official
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Title or Position | CEO
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Name | MARLON CARLO ESTELLA
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Credential | APRN, PMHNP-BC
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Telephone | 661-231-6422
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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