Provider Demographics
NPI:1396358602
Name:ALONZO, MARIE LIZBETH
Entity type:Individual
Prefix:MRS
First Name:MARIE
Middle Name:LIZBETH
Last Name:ALONZO
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:MARIE
Other - Middle Name:LIZBETH
Other - Last Name:DOUGHTY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:343 DELA VINA AVE
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-3974
Mailing Address - Country:US
Mailing Address - Phone:831-400-7030
Mailing Address - Fax:831-647-3004
Practice Address - Street 1:343 DELA VINA AVE
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-3974
Practice Address - Country:US
Practice Address - Phone:831-440-7030
Practice Address - Fax:831-647-3004
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-26
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW112670104100000X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker