Active NPI
Liza V Maravilla, LCSW
- Clinical Social Worker
- Corcoran, CA
National Provider Identifier
1124253588
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCS25244
- Practice address
- 900 Quebec Avenue
Corcoran, CA 93212 - Phone
- (559) 992-7100
- Fax
- (559) 992-7104
- NPI assigned
- May 28, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LCS25244 | CA | Primary |
Addresses
Primary practice location
900 Quebec Avenue
Corcoran, CA 93212
Mailing address
900 Quebec Avenue
Corcoran, CA 93212
Phone (559) 992-7100
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCS25244 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1243468800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1243468800000",
"number": "1124253588",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "900 QUEBEC AVENUE",
"city": "CORCORAN",
"state": "CA",
"postal_code": "93212",
"telephone_number": "559-992-7100",
"fax_number": "559-992-7104"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 QUEBEC AVENUE",
"city": "CORCORAN",
"state": "CA",
"postal_code": "93212",
"telephone_number": "559-992-7100",
"fax_number": "559-992-7104"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARAVILLA",
"first_name": "LIZA",
"middle_name": "V",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-05-28",
"last_updated": "2009-05-28",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCS25244",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Corcoran, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.