Healthcare Provider Details

I. General information

NPI: 1477276848
Provider Name (Legal Business Name): LIGIA CELESTE CRUZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2022
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

740 OAKLAND AVE APT 202
OAKLAND CA
94611-4561
US

IV. Provider business mailing address

740 OAKLAND AVE APT 202
OAKLAND CA
94611-4561
US

V. Phone/Fax

Practice location:
  • Phone: 347-889-1332
  • Fax:
Mailing address:
  • Phone: 347-889-1332
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number164511
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMT5104
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: