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NPI Code Detail

MEDICARE: MICHELLE NICOLE ELIAS NONE

MEDICARE: MICHELLE NICOLE ELIAS NONE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1373H00000XDay Training/Habilitation Specialist
2106S00000XBehavior Technician

General Provider Information

NPI Number : 1093471294
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELLE NICOLE ELIAS NONE
Provider Business Mailing Address
First Line : 21535 HAWTHORNE BLVD STE 102
Second Line :
City : TORRANCE
State : CA
Zip : 90503-6626
Country : US
Telephone Number : 310-817-2177
Fax Number :
Provider Business Practice Location Address
First Line : 21535 HAWTHORNE BLVD STE 102
Second Line :
City : TORRANCE
State : CA
Zip : 90503-6626
Country : US
Telephone Number : 310-817-2177
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/11/2021
Last Update Date : 01/21/2026

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