Provider Demographics
NPI:1922467182
Name:NAVARRO, LYZETTE (ASW)
Entity Type:Individual
Prefix:
First Name:LYZETTE
Middle Name:
Last Name:NAVARRO
Suffix:
Gender:F
Credentials:ASW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5815 STODDARD RD STE 600
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95356-9041
Mailing Address - Country:US
Mailing Address - Phone:209-543-1874
Mailing Address - Fax:209-543-1869
Practice Address - Street 1:5815 STODDARD RD STE 600
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95356-9041
Practice Address - Country:US
Practice Address - Phone:209-543-1874
Practice Address - Fax:209-543-1869
Is Sole Proprietor?:No
Enumeration Date:2016-02-16
Last Update Date:2016-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW664601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical