Provider Demographics
NPI:1043184500
Name:ENRIQUEZ, LOURDES ISABEL
Entity type:Individual
Prefix:MS
First Name:LOURDES
Middle Name:ISABEL
Last Name:ENRIQUEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2230 W. CHAPMAN AVE
Mailing Address - Street 2:SUITE 222
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868
Mailing Address - Country:US
Mailing Address - Phone:714-335-9672
Mailing Address - Fax:
Practice Address - Street 1:2230 W. CHAPMAN AVE
Practice Address - Street 2:SUITE 222
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868
Practice Address - Country:US
Practice Address - Phone:714-335-9672
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-30
Last Update Date:2025-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician