Provider Demographics
NPI:1376179887
Name:CAPOBIANCO-NARANJOFLORES, LISA KAY (ACSW)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:KAY
Last Name:CAPOBIANCO-NARANJOFLORES
Suffix:
Gender:F
Credentials:ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7018 BLAIR RD
Mailing Address - Street 2:
Mailing Address - City:CALIPATRIA
Mailing Address - State:CA
Mailing Address - Zip Code:92233-9633
Mailing Address - Country:US
Mailing Address - Phone:760-348-7000
Mailing Address - Fax:
Practice Address - Street 1:7018 BLAIR RD
Practice Address - Street 2:
Practice Address - City:CALIPATRIA
Practice Address - State:CA
Practice Address - Zip Code:92233-9633
Practice Address - Country:US
Practice Address - Phone:760-348-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-16
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA114937390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program