Provider Demographics
NPI:1215679691
Name:ARELLANO, LIZA ANA (LCSW)
Entity type:Individual
Prefix:MRS
First Name:LIZA
Middle Name:ANA
Last Name:ARELLANO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MISS
Other - First Name:LIZA
Other - Middle Name:ANA
Other - Last Name:FIMBRES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12625 FREDERICK ST STE I-5120
Mailing Address - Street 2:
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92553-5216
Mailing Address - Country:US
Mailing Address - Phone:951-237-3211
Mailing Address - Fax:
Practice Address - Street 1:10255 CORAL LN
Practice Address - Street 2:
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92557-2877
Practice Address - Country:US
Practice Address - Phone:951-237-3211
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-07
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW829601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical