Provider Demographics
NPI:1992263867
Name:LLERENAS, YESENIA (THERAPIST)
Entity type:Individual
Prefix:
First Name:YESENIA
Middle Name:
Last Name:LLERENAS
Suffix:
Gender:F
Credentials:THERAPIST
Other - Prefix:
Other - First Name:YESENIA
Other - Middle Name:
Other - Last Name:LLERENAS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:THERAPIST
Mailing Address - Street 1:17564 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-4464
Mailing Address - Country:US
Mailing Address - Phone:818-516-3957
Mailing Address - Fax:
Practice Address - Street 1:CHILDREN'S INSTITUTE INC
Practice Address - Street 2:1500 HUGHES WAY #100
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90810
Practice Address - Country:US
Practice Address - Phone:213-252-5861
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-08
Last Update Date:2020-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA103084106H00000X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health