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General NPI Number Information
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NPI Number | 1952953614
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Entity Type | Individual
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Provider Name | LIZETH NIEBLA-BACA LMFT
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Gender | Female
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Dates
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Enumeration Date | 07/12/2019
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Last Update Date | 08/11/2023
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Provider Practice Location Address
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Address Line | 27851 BRADLEY RD STE 102
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City | MENIFEE
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State | CA
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Zip | 92586-2213
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Country | US
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Telephone | 951-297-7878
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Fax | 951-297-3914
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Provider Business Mailing Address
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Address Line | 29219 SUNDIAL CIR
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City | MENIFEE
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State | CA
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Zip | 92584-7363
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Country | US
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Telephone | 951-375-6968
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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 | 135050
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License Number State | CA
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