Healthcare Provider Details

I. General information

NPI: 1275458408
Provider Name (Legal Business Name): ELIZABETH ANNE MCCREARY MS, CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 N ACACIA AVE
FULLERTON CA
92831-2102
US

IV. Provider business mailing address

1761 N HALE AVE
FULLERTON CA
92831-1243
US

V. Phone/Fax

Practice location:
  • Phone: 714-926-5601
  • Fax: 714-447-7793
Mailing address:
  • Phone: 714-926-5601
  • Fax: 714-447-7793

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number12043
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: