Provider Demographics
NPI:1386997401
Name:GARCIA RIVAS, ELIZABETH (LMFT)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:GARCIA RIVAS
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 1:172 N TUSTIN ST STE 308
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92867-7780
Mailing Address - Country:US
Mailing Address - Phone:714-274-5744
Mailing Address - Fax:
Practice Address - Street 1:172 N TUSTIN ST
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92867-7780
Practice Address - Country:US
Practice Address - Phone:714-274-5744
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-26
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CA94886106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program