Provider Demographics
NPI:1699020644
Name:VILLASENOR, VANESSA DANIELLE (LMFT)
Entity Type:Individual
Prefix:
First Name:VANESSA
Middle Name:DANIELLE
Last Name:VILLASENOR
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:591 CAMINO DE LA REINA STE 802
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-3110
Mailing Address - Country:US
Mailing Address - Phone:858-519-8002
Mailing Address - Fax:
Practice Address - Street 1:591 CAMINO DE LA REINA STE 820
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-3110
Practice Address - Country:US
Practice Address - Phone:858-519-8002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-16
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist