Provider Demographics
NPI:1912695420
Name:COVARRUBIAS, LIZBETH
Entity Type:Individual
Prefix:
First Name:LIZBETH
Middle Name:
Last Name:COVARRUBIAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 SARATOGA AVE UNIT 1113
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-6411
Mailing Address - Country:US
Mailing Address - Phone:909-664-3180
Mailing Address - Fax:
Practice Address - Street 1:725 E MAIN ST
Practice Address - Street 2:
Practice Address - City:SANTA PAULA
Practice Address - State:CA
Practice Address - Zip Code:93060-2748
Practice Address - Country:US
Practice Address - Phone:805-933-8480
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-24
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator