Provider Demographics
NPI:1811971054
Name:SUZUKI, ELIZABETH KEI (LCSW)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:KEI
Last Name:SUZUKI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:KEI
Other - Last Name:ZUCKERWISE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:3541 ADAMSVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:CALABASAS
Mailing Address - State:CA
Mailing Address - Zip Code:91302-5802
Mailing Address - Country:US
Mailing Address - Phone:818-481-2156
Mailing Address - Fax:
Practice Address - Street 1:3541 ADAMSVILLE AVE
Practice Address - Street 2:
Practice Address - City:CALABASAS
Practice Address - State:CA
Practice Address - Zip Code:91302-5802
Practice Address - Country:US
Practice Address - Phone:818-481-2156
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-01
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS10585104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0673432Medicaid
CAR36405Medicare ID - Type Unspecified