Provider Demographics
NPI:1639454705
Name:LIRA, VERONICA (MSW)
Entity type:Individual
Prefix:
First Name:VERONICA
Middle Name:
Last Name:LIRA
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:VERONICA
Other - Middle Name:
Other - Last Name:DIEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1065 E OCEAN BLVD APT 14
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90802-5572
Mailing Address - Country:US
Mailing Address - Phone:562-881-0570
Mailing Address - Fax:
Practice Address - Street 1:9901 ARTESIA BLVD
Practice Address - Street 2:
Practice Address - City:BELLFLOWER
Practice Address - State:CA
Practice Address - Zip Code:90706-6713
Practice Address - Country:US
Practice Address - Phone:562-881-0570
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-20
Last Update Date:2014-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator