Individual provider Active NPI

Diana Siguenza Lizarde, LCSW

  • Clinical Social Worker
  • Long Beach, CA
National Provider Identifier
1811270002
Registry record updated Mar 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
66836 Issued in CA
Practice address
4401 Atlantic Ave Ste 200
Long Beach, CA 90807-2264
Phone
(213) 640-9256
Fax
(562) 685-0459
NPI assigned
Sep 23, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 66836 CA Primary
Mental Health Counselor 101YM0800X
Clinical Social Worker 1041C0700X

Addresses

Primary practice location

4401 Atlantic Ave Ste 200
Long Beach, CA 90807-2264

Mailing address

4401 Atlantic Ave Ste 200
Long Beach, CA 90807-2264
Phone (213) 640-9256

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20201103002925 CA Practitioner - Clinical Social Worker 7113337064 Reassigns benefits to 1 organization
Practice locations: Long Beach, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4433 E Village Rd
Long Beach, CA 90808-1505
Phone (213) 640-9256

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
66836CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Empatia Counseling Services a Licensed Clinical Social Worker Co Clinical CurrentSince Jul 29, 2023 Accepting new patients

Locations

3605 Long Beach Blvd
Ste 108A
Long Beach, CA 90807
Phone (213) 640-9256

4401 Atlantic Ave
Ste 200
Long Beach, CA 90807
Phone (562) 984-2038

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1316736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709769600000",
    "number": "1811270002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4401 ATLANTIC AVE STE 200",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908072264",
            "telephone_number": "213-640-9256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 ATLANTIC AVE STE 200",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908072264",
            "telephone_number": "213-640-9256",
            "fax_number": "562-685-0459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIGUENZA LIZARDE",
        "first_name": "DIANA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-23",
        "last_updated": "2024-03-07",
        "certification_date": "2024-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "66836",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.