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NPI Code Detail

MEDICARE: ELENA CAVAZOS

MEDICARE: ELENA CAVAZOS
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1255462602
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELENA CAVAZOS
Provider Business Mailing Address
First Line : 1207 E FRUIT ST
Second Line :
City : SANTA ANA
State : CA
Zip : 92701-4206
Country : US
Telephone Number : 714-953-5908
Fax Number :
Provider Business Practice Location Address
First Line : 1207 E FRUIT ST
Second Line :
City : SANTA ANA
State : CA
Zip : 92701-4206
Country : US
Telephone Number : 714-953-5908
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/08/2007
Last Update Date : 02/04/2011

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Directions to “ ELENA CAVAZOS ” Practice Location

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