Provider Demographics
NPI:1013632637
Name:FELIZ, COLIJIA
Entity Type:Individual
Prefix:
First Name:COLIJIA
Middle Name:
Last Name:FELIZ
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:PO BOX 3719
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93278-3719
Mailing Address - Country:US
Mailing Address - Phone:559-242-1220
Mailing Address - Fax:
Practice Address - Street 1:425 E OAK AVE STE 201
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93291-5035
Practice Address - Country:US
Practice Address - Phone:559-242-1220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-06
Last Update Date:2022-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW984281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical