Provider Demographics
NPI:1609203033
Name:TOSCANO, LIZETH ALCANTARA
Entity Type:Individual
Prefix:
First Name:LIZETH
Middle Name:ALCANTARA
Last Name:TOSCANO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LIZETH
Other - Middle Name:ADRIANA
Other - Last Name:ALCANTARA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:14221 MAR VISTA ST
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90602-2640
Mailing Address - Country:US
Mailing Address - Phone:831-214-9152
Mailing Address - Fax:
Practice Address - Street 1:14221 MAR VISTA ST
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90602-2640
Practice Address - Country:US
Practice Address - Phone:831-214-9152
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-30
Last Update Date:2022-07-22
Deactivation Date:2022-05-19
Deactivation Code:
Reactivation Date:2022-07-21
Provider Licenses
StateLicense IDTaxonomies
CA1034691041C0700X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program