Provider Demographics
NPI:1992095749
Name:MARISCAL, LOLITA
Entity type:Individual
Prefix:
First Name:LOLITA
Middle Name:
Last Name:MARISCAL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2390 E ORANGEWOOD AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92806-6141
Mailing Address - Country:US
Mailing Address - Phone:714-543-4333
Mailing Address - Fax:714-543-4398
Practice Address - Street 1:2390 E. ORANGEWOOD AVE.,
Practice Address - Street 2:SUITE 300
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92806-6141
Practice Address - Country:US
Practice Address - Phone:714-543-4333
Practice Address - Fax:714-543-4398
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-13
Last Update Date:2015-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker