Provider Demographics
NPI:1336454628
Name:FELIZ, LELA FELIZ EVELYN (CAADAC)
Entity Type:Individual
Prefix:
First Name:LELA FELIZ
Middle Name:EVELYN
Last Name:FELIZ
Suffix:
Gender:F
Credentials:CAADAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5036 EARLCORT CIR
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95842-1737
Mailing Address - Country:US
Mailing Address - Phone:916-348-6377
Mailing Address - Fax:
Practice Address - Street 1:5036 EARLCORT CIR
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95842-1737
Practice Address - Country:US
Practice Address - Phone:916-348-6377
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-11
Last Update Date:2010-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA084199101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)