Provider Demographics
NPI:1528263704
Name:PEZOA, ELIZABETH D (LCSW, LPCC)
Entity type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:D
Last Name:PEZOA
Suffix:
Gender:F
Credentials:LCSW, LPCC
Other - Prefix:MS
Other - First Name:ELIZABETH
Other - Middle Name:D
Other - Last Name:PEZOA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW, LPCC
Mailing Address - Street 1:1 CALIFORNIA ST STE 2300
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94111-5424
Mailing Address - Country:US
Mailing Address - Phone:855-431-5533
Mailing Address - Fax:
Practice Address - Street 1:1 CALIFORNIA ST STE 2300
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94111-5424
Practice Address - Country:US
Practice Address - Phone:855-431-5533
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-18
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALPCC817101YP2500X
CALCSW223231041C0700X
CALCS223231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional