Ivett Lizardo-Gonzalez

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW126147 Issued in CA

Practice address

9631 Business Center Drive
BLDG. 14, Ste. D
Rancho Cucamonga, CA 91730-4554

Phone

(909) 948-5747

NPI assigned

Feb 8, 2021

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2020

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Spring to Autumn Family Counseling, Inc.

  • Marriage & Family Therapist
  • Redlands, CA
  • NPI 1689056442
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1612742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733702400000",
    "number": "1417549874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3216 FLAXTON ST",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917671414",
            "telephone_number": "626-460-9012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9631 BUSINESS CENTER DRIVE",
            "address_2": "BLDG. 14, STE. D",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917304554",
            "telephone_number": "909-948-5747"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "23311 Dracaea Ave",
            "address_purpose": "LOCATION",
            "city": "Moreno Valley",
            "state": "CA",
            "postal_code": "925533201",
            "country_code": "US",
            "telephone_number": "951-571-4689",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9645 Arrow Route Bldg. 5",
            "address_2": "Ste. A",
            "address_purpose": "LOCATION",
            "city": "Rancho Cucamonga",
            "state": "CA",
            "postal_code": "91730",
            "country_code": "US",
            "telephone_number": "909-948-5747",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIZARDO-GONZALEZ",
        "first_name": "IVETT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-08",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW126147",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF BEHAVIORAL SCIENCES",
            "identifier": "LCSW126147",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ji Liu
• Jinying Liu
• Living Hope Counseling Center
• David Anthony Lizama
• Vickie L Lizardi
• Timothy Loaiza
• Eugene D. Locken, D.O.
• Stefanie Lockhart-Pettaway, PSY.D, MSW
• Renae Elisa Loera
• Stephanie Lofton

• Clinical Social Worker in Rancho Cucamonga, CA
• Providers in Rancho Cucamonga, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.