Provider Demographics
NPI:1710328372
Name:CRUZ, ALICIA N (LCSW)
Entity type:Individual
Prefix:
First Name:ALICIA
Middle Name:N
Last Name:CRUZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 TIMBRE
Mailing Address - Street 2:
Mailing Address - City:RANCHO SANTA MARGARITA
Mailing Address - State:CA
Mailing Address - Zip Code:92688-2040
Mailing Address - Country:US
Mailing Address - Phone:949-285-9017
Mailing Address - Fax:
Practice Address - Street 1:19 TIMBRE
Practice Address - Street 2:
Practice Address - City:RANCHO SANTA MARGARITA
Practice Address - State:CA
Practice Address - Zip Code:92688-2040
Practice Address - Country:US
Practice Address - Phone:949-285-9017
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-11
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1173691041C0700X
COCSW.099255801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical