Provider Demographics
NPI:1346692696
Name:MONROY, LIZZET
Entity Type:Individual
Prefix:
First Name:LIZZET
Middle Name:
Last Name:MONROY
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 1:78710 AVENIDA LA FONDA
Mailing Address - Street 2:
Mailing Address - City:LA QUINTA
Mailing Address - State:CA
Mailing Address - Zip Code:92253-2805
Mailing Address - Country:US
Mailing Address - Phone:530-680-3072
Mailing Address - Fax:
Practice Address - Street 1:78710 AVENIDA LA FONDA
Practice Address - Street 2:
Practice Address - City:LA QUINTA
Practice Address - State:CA
Practice Address - Zip Code:92253-2805
Practice Address - Country:US
Practice Address - Phone:530-680-3072
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA100562106H00000X, 390200000X
CA126547106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program