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General NPI Number Information
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NPI Number | 1124648266
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Entity Type | Organization
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Legal Business Name | LIZZETTE VESCERA MARRIAGE AND FAMILY THERAPY
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Dates
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Enumeration Date | 04/18/2020
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Last Update Date | 12/17/2024
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Provider Practice Location Address
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Address Line | 2890 PIO PICO DR STE 200A
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City | CARLSBAD
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State | CA
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Zip | 92008-1558
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Country | US
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Telephone | 562-257-6528
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Fax | 866-506-5725
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Provider Business Mailing Address
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Address Line | 1326 VIA ISIDRO
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City | OCEANSIDE
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State | CA
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Zip | 92056-5628
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Country | US
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Telephone | 562-257-6528
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Fax | 866-506-5725
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Authorized Official
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Title or Position | OWNER
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Name | LIZZETTE VESCERA
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Credential | LMFT
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Telephone | 562-257-6528
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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