Healthcare Provider Details

I. General information

NPI: 1679983886
Provider Name (Legal Business Name): MS. MARITZA LIZZETH NORIEGA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/28/2014
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

950 S BASCOM AVE
SAN JOSE CA
95128-3536
US

IV. Provider business mailing address

950 S BASCOM AVE
SAN JOSE CA
95128-3536
US

V. Phone/Fax

Practice location:
  • Phone: 408-471-4261
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: