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General NPI Number Information
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NPI Number | 1912505793
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Entity Type | Organization
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Legal Business Name | THERAPAZ COUNSELING, A LICENSED CLINICAL SOCIAL WORKER CORPORATION
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Dates
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Enumeration Date | 10/13/2020
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Last Update Date | 10/13/2020
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Provider Practice Location Address
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Address Line | 17772 IRVINE BLVD STE 102
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City | TUSTIN
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State | CA
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Zip | 92780-3233
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Country | US
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Telephone | 714-482-3774
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Fax |
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Provider Business Mailing Address
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Address Line | 948 N IROQUOIS AVE
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City | ANAHEIM
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State | CA
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Zip | 92801-3505
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Country | US
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Telephone | 714-878-3567
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ELIZABETH MOJICA HERNANDEZ
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Credential | LCSW
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Telephone | 714-878-3567
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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 |
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License Number State |
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