=====================================================
General NPI Number Information
=====================================================
NPI Number | 1942478821
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LORENA CRUZ-RODRIGUEZ LMFT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/13/2008
-----------------------------------------------------
Last Update Date | 05/05/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3600 OCEAN AVE
-----------------------------------------------------
City | CARMEL
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93923-8239
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 831-624-1821
-----------------------------------------------------
Fax | 831-626-4313
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3600 OCEAN AVE
-----------------------------------------------------
City | CARMEL
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93923-8239
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 831-624-1821
-----------------------------------------------------
Fax | 831-626-4313
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106H00000X
-----------------------------------------------------
Taxonomy Name | Marriage & Family Therapist
-----------------------------------------------------
License Number | 52719
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------