Provider Demographics
NPI:1396817326
Name:CRUZ, LISA D (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:D
Last Name:CRUZ
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:MS
Other - First Name:LISA
Other - Middle Name:D
Other - Last Name:ALVAREZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT
Mailing Address - Street 1:2615 S MILLER ST STE 106
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93455-1775
Mailing Address - Country:US
Mailing Address - Phone:805-570-8741
Mailing Address - Fax:
Practice Address - Street 1:2615 S MILLER ST STE 106
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93455-1775
Practice Address - Country:US
Practice Address - Phone:805-570-8741
Practice Address - Fax:805-739-8863
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2022-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA92560106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist