Healthcare Provider Details

I. General information

NPI: 1104652817
Provider Name (Legal Business Name): LEZLIE LIZET CRUZ ASW, MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/10/2024
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1222 W LACEY BLVD
HANFORD CA
93230-5901
US

IV. Provider business mailing address

PO BOX 2357
HURON CA
93234-2357
US

V. Phone/Fax

Practice location:
  • Phone: 559-235-9239
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberASW140288
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: