Provider Demographics
NPI:1023394293
Name:ENRIQUEZ, LUZ
Entity Type:Individual
Prefix:
First Name:LUZ
Middle Name:
Last Name:ENRIQUEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6635 FLORENCE AVE
Mailing Address - Street 2:
Mailing Address - City:BELL GARDENS
Mailing Address - State:CA
Mailing Address - Zip Code:90201-4909
Mailing Address - Country:US
Mailing Address - Phone:562-927-1656
Mailing Address - Fax:562-928-6500
Practice Address - Street 1:6635 FLORENCE AVE
Practice Address - Street 2:
Practice Address - City:BELL GARDENS
Practice Address - State:CA
Practice Address - Zip Code:90201-4909
Practice Address - Country:US
Practice Address - Phone:562-927-1656
Practice Address - Fax:562-928-6500
Is Sole Proprietor?:No
Enumeration Date:2011-11-01
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health