Individual
AMANDA E CRUZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12142 CENTRAL AVE # 177, CHINO, CA 91710-2420
(626) 779-8583
Mailing address
PO BOX 310949, FONTANA, CA 92331-0949
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
98060
CA
1041C0700X
Clinical Social Worker
98060
CA
Other
Enumeration date
05/10/2021
Last updated
01/10/2023
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