Doctor Name: | MS. LIZA V MARAVILLA |
NPI Number: | 1124253588 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | LCS25244 |
Business Practice Address: | 900 Quebec Avenue Corcoran, CA - 93212 |
Business Phone Number: | 5599927100 |
Business Fax Number: | 5599927104 |
Mailing Address: | 900 Quebec Avenue, CORCORAN |
State: | CA |
Postal Code: | 93212 |
Phone Number: | 5599927100 |
Fax Number: | 5599927104 |
NPI Enumeration Date: | 05/28/2009 |
NPI Last Update Date: | 05/28/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | LCS25244 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |