Provider Demographics
NPI:1689127136
Name:VIZCARRA-MARQUEZ, LORENA
Entity type:Individual
Prefix:
First Name:LORENA
Middle Name:
Last Name:VIZCARRA-MARQUEZ
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:XARENI THERAPY
Mailing Address - Street 2:P.O. BOX 1006
Mailing Address - City:LAKEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90714-9998
Mailing Address - Country:US
Mailing Address - Phone:562-285-3901
Mailing Address - Fax:
Practice Address - Street 1:4955 CASTANA AVE APT 3
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90712-7877
Practice Address - Country:US
Practice Address - Phone:562-285-3901
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-02
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW83342101YM0800X
101YM0800X
CALCSW1027281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health