Provider Demographics
NPI:1396873121
Name:DIAZ-AMBRIZ, ELIZABETH (LMFT)
Entity type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:
Last Name:DIAZ-AMBRIZ
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:OLGA
Other - Middle Name:ELIZABETH
Other - Last Name:DIAZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT
Mailing Address - Street 1:6 CENTERPOINTE DR STE 700
Mailing Address - Street 2:
Mailing Address - City:LA PALMA
Mailing Address - State:CA
Mailing Address - Zip Code:90623-2545
Mailing Address - Country:US
Mailing Address - Phone:562-454-6563
Mailing Address - Fax:
Practice Address - Street 1:6 CENTERPOINTE DR STE 700
Practice Address - Street 2:
Practice Address - City:LA PALMA
Practice Address - State:CA
Practice Address - Zip Code:90623-2545
Practice Address - Country:US
Practice Address - Phone:562-454-6563
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53125106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist