Provider Demographics
NPI:1982200093
Name:CRUZ, ALEYA ANN
Entity Type:Individual
Prefix:
First Name:ALEYA
Middle Name:ANN
Last Name:CRUZ
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 1:333 VALLE VISTA AVE
Mailing Address - Street 2:
Mailing Address - City:VALLEJO
Mailing Address - State:CA
Mailing Address - Zip Code:94590-3359
Mailing Address - Country:US
Mailing Address - Phone:707-342-1336
Mailing Address - Fax:
Practice Address - Street 1:333 VALLE VISTA AVE
Practice Address - Street 2:
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94590-3359
Practice Address - Country:US
Practice Address - Phone:707-342-1336
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-05
Last Update Date:2020-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA09513990OtherKAISER