Provider Demographics
NPI:1306471206
Name:CRUZ, ARASELI
Entity type:Individual
Prefix:
First Name:ARASELI
Middle Name:
Last Name:CRUZ
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 1:2677 ZOE AVE STE 114
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90255-6995
Mailing Address - Country:US
Mailing Address - Phone:323-923-9559
Mailing Address - Fax:
Practice Address - Street 1:2677 ZOE AVE STE 114
Practice Address - Street 2:
Practice Address - City:HUNTINGTON PARK
Practice Address - State:CA
Practice Address - Zip Code:90255-6995
Practice Address - Country:US
Practice Address - Phone:323-923-9559
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-11
Last Update Date:2020-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor
No172V00000XOther Service ProvidersCommunity Health Worker