Provider Demographics
NPI:1831645068
Name:FLORES, LIANNA REBECCA (LCSW)
Entity Type:Individual
Prefix:MISS
First Name:LIANNA
Middle Name:REBECCA
Last Name:FLORES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 E. VIRGINIA ST., SUITE 100
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95112-5817
Mailing Address - Country:US
Mailing Address - Phone:408-918-2618
Mailing Address - Fax:408-579-6143
Practice Address - Street 1:160 E. VIRGINIA ST., SUITE 100
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95112-5817
Practice Address - Country:US
Practice Address - Phone:408-918-2618
Practice Address - Fax:408-579-6143
Is Sole Proprietor?:No
Enumeration Date:2016-08-28
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA71505101YM0800X
CA99647101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health