Provider Demographics
NPI:1467602417
Name:NINO, LIZABETH ESTELLE
Entity Type:Individual
Prefix:MS
First Name:LIZABETH
Middle Name:ESTELLE
Last Name:NINO
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 1:9901 PARAMOUNT BLVD
Mailing Address - Street 2:SUITE #250
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90240-3843
Mailing Address - Country:US
Mailing Address - Phone:562-400-6951
Mailing Address - Fax:
Practice Address - Street 1:9901 PARAMOUNT BLVD
Practice Address - Street 2:SUITE # 250
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90240-3843
Practice Address - Country:US
Practice Address - Phone:562-207-4272
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-26
Last Update Date:2014-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC81391106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist