Healthcare Provider Details

I. General information

NPI: 1093115453
Provider Name (Legal Business Name): ELIZABETH MUNOZ LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/03/2014
Last Update Date: 01/28/2025
Certification Date: 01/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 CENTERPOINTE DR SUITE 700
LA PALMA CA
90623
US

IV. Provider business mailing address

6 CENTERPOINTE DR SUITE 700
LA PALMA CA
90623
US

V. Phone/Fax

Practice location:
  • Phone: 562-670-3652
  • Fax:
Mailing address:
  • Phone: 562-670-3652
  • Fax: 714-680-8233

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number103602
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: