Provider Demographics
NPI:1427178003
Name:CRUZ, MARIA R (LCSW)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:R
Last Name:CRUZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10529 FLORALITA AVE
Mailing Address - Street 2:APT 34
Mailing Address - City:SUNLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91040-2827
Mailing Address - Country:US
Mailing Address - Phone:818-293-8709
Mailing Address - Fax:
Practice Address - Street 1:6736 LAUREL CANYOUN BLVD
Practice Address - Street 2:STE 200
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91606
Practice Address - Country:US
Practice Address - Phone:818-755-8786
Practice Address - Fax:818-755-8789
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2016-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW 717101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical