Healthcare Provider Details

I. General information

NPI: 1740531490
Provider Name (Legal Business Name): FELICIA LANET CRUZ LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2012
Last Update Date: 09/19/2026
Certification Date: 09/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15901 HAWTHORNE BLVD STE 260
LAWNDALE CA
90260-5804
US

IV. Provider business mailing address

15901 HAWTHORNE BLVD STE 260
LAWNDALE CA
90260-5804
US

V. Phone/Fax

Practice location:
  • Phone: 858-519-8002
  • Fax:
Mailing address:
  • Phone: 858-519-8002
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number111389
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: