Provider Demographics
NPI:1427764216
Name:CRUZ, MARISSA ALLEN (LMFT 151681)
Entity type:Individual
Prefix:
First Name:MARISSA
Middle Name:ALLEN
Last Name:CRUZ
Suffix:
Gender:F
Credentials:LMFT 151681
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3331 FOURNIER ST
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93033-5463
Mailing Address - Country:US
Mailing Address - Phone:559-476-7548
Mailing Address - Fax:
Practice Address - Street 1:3331 FOURNIER ST
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93033-5463
Practice Address - Country:US
Practice Address - Phone:559-476-7548
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-25
Last Update Date:2025-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA151681106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist