Provider Demographics
NPI:1104658855
Name:RAYGOZA, MARITZA
Entity type:Individual
Prefix:
First Name:MARITZA
Middle Name:
Last Name:RAYGOZA
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 1:140 W GUINIDA LN
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92805-6101
Mailing Address - Country:US
Mailing Address - Phone:714-323-5133
Mailing Address - Fax:
Practice Address - Street 1:140 W GUINIDA LN
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92805-6101
Practice Address - Country:US
Practice Address - Phone:714-323-5133
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-19
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool