Individual
DEMETRAS DE LA CRUZ I
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
867 N FAIR OAKS AVE, PASADENA, CA 91103-3083
(626) 798-6793
Mailing address
867 N FAIR OAKS AVE, PASADENA, CA 91103-3083
(626) 798-6793
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
172V00000X
Community Health Worker
—
CA
225400000X
Rehabilitation Practitioner
—
—
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Enumeration date
06/09/2015
Last updated
05/08/2025
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