Provider Demographics
NPI:1679583512
Name:VAZQUEZ, LIZZETH (MSW)
Entity type:Individual
Prefix:MS
First Name:LIZZETH
Middle Name:
Last Name:VAZQUEZ
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1028 S CITRON ST
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92805-5566
Mailing Address - Country:US
Mailing Address - Phone:714-778-4626
Mailing Address - Fax:
Practice Address - Street 1:500 N EUCLID ST
Practice Address - Street 2:SUITE 300
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-5510
Practice Address - Country:US
Practice Address - Phone:714-871-5646
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker