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General NPI Number Information
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NPI Number | 1669029559
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Entity Type | Individual
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Provider Name | STACELYN NICOLE CERVANTES LMFT
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Gender | Female
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Dates
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Enumeration Date | 08/24/2019
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Last Update Date | 09/15/2025
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Provider Practice Location Address
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Address Line | 10927 DOWNEY AVE STE C
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City | DOWNEY
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State | CA
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Zip | 90241-3739
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Country | US
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Telephone | 626-664-1038
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 11084
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City | WHITTIER
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State | CA
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Zip | 90603-0084
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Country | US
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Telephone | 562-774-2114
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 106683
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License Number State | CA
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