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NPI Code Detail

MEDICARE: ALYSSA KATI CRUZ LCSW

MEDICARE: ALYSSA KATI CRUZ LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker121093CA

General Provider Information

NPI Number : 1144762279
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALYSSA KATI CRUZ LCSW
Provider Business Mailing Address
First Line : 6051 N FRESNO ST STE 201
Second Line :
City : FRESNO
State : CA
Zip : 93710-5280
Country : US
Telephone Number : 559-248-8550
Fax Number :
Provider Business Practice Location Address
First Line : 225 N MICHIGAN AVE STE 1430
Second Line :
City : CHICAGO
State : IL
Zip : 60601-7653
Country : US
Telephone Number : 312-766-6780
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/07/2016
Last Update Date : 03/27/2024

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Directions to “ ALYSSA KATI CRUZ LCSW” Practice Location

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