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General NPI Number Information
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NPI Number | 1639985930
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Entity Type | Individual
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Provider Name | VIVIANA YADIRA CRUZ-GARCIA LCSW
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Gender | Female
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Dates
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Enumeration Date | 12/10/2024
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Last Update Date | 12/13/2024
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Provider Practice Location Address
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Address Line | 1828 E CESAR E CHAVEZ AVE
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City | LOS ANGELES
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State | CA
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Zip | 90033-2400
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Country | US
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Telephone | 323-859-3634
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Fax | 323-987-1212
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Provider Business Mailing Address
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Address Line | 3318 FITHIAN AVE
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City | LOS ANGELES
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State | CA
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Zip | 90032-1911
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Country | US
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Telephone | 323-916-3003
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCSW121916
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License Number State | CA
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