Healthcare Provider Details

I. General information

NPI: 1598995235
Provider Name (Legal Business Name): ELANA REMAS ZAGORSKY LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2009
Last Update Date: 03/21/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

592 HERMES AVE
ENCINITAS CA
92024-2107
US

IV. Provider business mailing address

592 HERMES AVE
ENCINITAS CA
92024-2107
US

V. Phone/Fax

Practice location:
  • Phone: 619-977-5405
  • Fax:
Mailing address:
  • Phone: 619-977-5405
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number73040
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: