Healthcare Provider Details

I. General information

NPI: 1689153546
Provider Name (Legal Business Name): MELISSA FLOR DE LIZ LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MELISSA SALDANA-ALVAREZ LCSW

II. Dates (important events)

Enumeration Date: 08/11/2018
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

675 W FOOTHILL BLVD STE 200
CLAREMONT CA
91711-3475
US

IV. Provider business mailing address

675 W FOOTHILL BLVD STE 200
CLAREMONT CA
91711-3475
US

V. Phone/Fax

Practice location:
  • Phone: 925-282-1778
  • Fax: 415-296-5299
Mailing address:
  • Phone: 925-282-1778
  • Fax: 415-296-5299

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number140711
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: