Individual
LIZETTE IBANEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
800 SCENIC DR, MODESTO, CA 95350-6131
(209) 287-6431
Mailing address
420 E CANAL DR, TURLOCK, CA 95380-3936
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
CA
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
01/04/2016
Last updated
08/15/2022
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