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General NPI Number Information
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NPI Number | 1689466062
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Entity Type | Individual
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Provider Name | KAYLA ALYZA CRUZ
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Gender | Female
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Dates
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Enumeration Date | 05/21/2025
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Last Update Date | 05/21/2025
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Provider Practice Location Address
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Address Line | 1109 W SAN BERNARDINO RD STE 150
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City | COVINA
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State | CA
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Zip | 91722-4156
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Country | US
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Telephone | 626-634-2914
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Fax |
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Provider Business Mailing Address
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Address Line | 396 S CALIFORNIA AVE UNIT 102
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City | WEST COVINA
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State | CA
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Zip | 91793-3404
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Country | US
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Telephone |
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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 | 153675
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License Number State | CA
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