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General NPI Number Information
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NPI Number | 1083623516
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Entity Type | Organization
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Legal Business Name | LATINO PSYCHOLOGICAL AND SOCIAL SERVICES
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Dates
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Enumeration Date | 08/05/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 120 W 5TH ST STE300
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City | SANTA ANA
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State | CA
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Zip | 92701-4641
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Country | US
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Telephone | 714-834-0757
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Fax | 714-834-0848
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Provider Business Mailing Address
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Address Line | 120 W 5TH ST STE300
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City | SANTA ANA
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State | CA
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Zip | 92701-4641
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Country | US
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Telephone | 714-834-0757
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Fax | 714-834-0848
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PATRICIA LAZALDE
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Credential |
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Telephone | 714-834-0757
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PSY13614
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License Number State | CA
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