Provider Demographics
NPI:1114369568
Name:CRUZ, YENI PATRICIA
Entity Type:Individual
Prefix:
First Name:YENI
Middle Name:PATRICIA
Last Name:CRUZ
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 1:1819 S BERENDO ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90006-4414
Mailing Address - Country:US
Mailing Address - Phone:323-590-9823
Mailing Address - Fax:
Practice Address - Street 1:1819 S BERENDO ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90006-4414
Practice Address - Country:US
Practice Address - Phone:323-590-9823
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-26
Last Update Date:2013-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical