Provider Demographics
NPI:1568590982
Name:CRUZ, MARIA ELIZABETH (LCSW)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:ELIZABETH
Last Name:CRUZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:ELIZABETH
Other - Last Name:ROMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:PO BOX 4053
Mailing Address - Street 2:
Mailing Address - City:COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91723-0453
Mailing Address - Country:US
Mailing Address - Phone:000-000-0000
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 4053
Practice Address - Street 2:
Practice Address - City:COVINA
Practice Address - State:CA
Practice Address - Zip Code:91723-0453
Practice Address - Country:US
Practice Address - Phone:000-000-0000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2025-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 279091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CABON0028OtherMIS #