Provider Demographics
NPI:1306698386
Name:CAMBALIZA, ALICIA LYNN (LMFT)
Entity type:Individual
Prefix:MRS
First Name:ALICIA
Middle Name:LYNN
Last Name:CAMBALIZA
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40119 PALMETTO DR
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93551-3557
Mailing Address - Country:US
Mailing Address - Phone:661-350-4413
Mailing Address - Fax:
Practice Address - Street 1:2601 W ROSAMOND BLVD
Practice Address - Street 2:
Practice Address - City:ROSAMOND
Practice Address - State:CA
Practice Address - Zip Code:93560-6434
Practice Address - Country:US
Practice Address - Phone:661-256-5060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-03
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA141824101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health