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General NPI Number Information
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NPI Number | 1417585415
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Entity Type | Individual
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Provider Name | MARIELA LOURDES CACERES
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Gender | Female
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Dates
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Enumeration Date | 03/27/2020
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Last Update Date | 05/27/2025
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Provider Practice Location Address
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Address Line | 44444 20TH ST W
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City | LANCASTER
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State | CA
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Zip | 93534-2714
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Country | US
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Telephone | 616-951-0070
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Fax |
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Provider Business Mailing Address
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Address Line | 2103 SANDSTONE CT
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City | PALMDALE
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State | CA
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Zip | 93551-4100
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Country | US
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Telephone | 323-972-4043
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFT150822
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License Number State | CA
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