Healthcare Provider Details

I. General information

NPI: 1003734344
Provider Name (Legal Business Name): ELIZABETH MARIE LOUGHRIDGE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7441 GARDEN GROVE BLVD
GARDEN GROVE CA
92841-4209
US

IV. Provider business mailing address

1652 IOWA ST UNIT A
COSTA MESA CA
92626-2062
US

V. Phone/Fax

Practice location:
  • Phone: 714-799-3030
  • Fax:
Mailing address:
  • Phone: 626-532-5104
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License NumberSPA8847
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: