Provider Demographics
NPI:1285455311
Name:VILLASENOR, ABEL (LCSW)
Entity type:Individual
Prefix:MR
First Name:ABEL
Middle Name:
Last Name:VILLASENOR
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:938 GRETTA AVE
Mailing Address - Street 2:
Mailing Address - City:LA PUENTE
Mailing Address - State:CA
Mailing Address - Zip Code:91744-3308
Mailing Address - Country:US
Mailing Address - Phone:626-488-5901
Mailing Address - Fax:
Practice Address - Street 1:938 GRETTA AVE
Practice Address - Street 2:
Practice Address - City:LA PUENTE
Practice Address - State:CA
Practice Address - Zip Code:91744-3308
Practice Address - Country:US
Practice Address - Phone:626-488-5901
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-22
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1125921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical