Healthcare Provider Details

I. General information

NPI: 1124510995
Provider Name (Legal Business Name): LUCIA PIRIR XOCHIMITL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2018
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45124 10TH ST W
LANCASTER CA
93534-2310
US

IV. Provider business mailing address

1301 PINE AVE
LONG BEACH CA
90813-3124
US

V. Phone/Fax

Practice location:
  • Phone: 323-201-4516
  • Fax:
Mailing address:
  • Phone: 562-595-1159
  • Fax: 562-486-4661

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number113104
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: