Provider Demographics
NPI:1568260453
Name:CABEZAS, MARITZA (PPS, LPCC)
Entity type:Individual
Prefix:
First Name:MARITZA
Middle Name:
Last Name:CABEZAS
Suffix:
Gender:
Credentials:PPS, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2634 KELLOGG PARK DR
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91768-2607
Mailing Address - Country:US
Mailing Address - Phone:626-806-2340
Mailing Address - Fax:
Practice Address - Street 1:2634 KELLOGG PARK DR
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91768-2607
Practice Address - Country:US
Practice Address - Phone:626-806-2340
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-05
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3979101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor