Healthcare Provider Details

I. General information

NPI: 1043136831
Provider Name (Legal Business Name): SAVANNAH JESSICA LIZARRAGA MSN, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/25/2026
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4132 KATELLA AVE STE 200
LOS ALAMITOS CA
90720-3496
US

IV. Provider business mailing address

14670 DANBROOK DR
WHITTIER CA
90604-1044
US

V. Phone/Fax

Practice location:
  • Phone: 562-312-1777
  • Fax:
Mailing address:
  • Phone: 562-292-0702
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95039773
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: