Provider Demographics
NPI:1356147052
Name:SANTA CRUZ, AMBER MARIE PABLO (LCSW)
Entity type:Individual
Prefix:
First Name:AMBER MARIE
Middle Name:PABLO
Last Name:SANTA CRUZ
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:
Other - Last Name:SANTA CRUZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5098 N OCEAN AVE
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85704-2545
Mailing Address - Country:US
Mailing Address - Phone:520-848-6831
Mailing Address - Fax:
Practice Address - Street 1:5098 N OCEAN AVE
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-2545
Practice Address - Country:US
Practice Address - Phone:520-848-6831
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-22
Last Update Date:2025-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW-214261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical