Healthcare Provider Details
I. General information
NPI: 1013700186
Provider Name (Legal Business Name): ELIZABETH MIEKO ADAMS MM, MT-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/22/2025
Last Update Date: 05/22/2025
Certification Date: 05/22/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3652 MICHELSON DR RM 200
IRVINE CA
92612-1727
US
IV. Provider business mailing address
3652 MICHELSON DR RM 200
IRVINE CA
92612-1727
US
V. Phone/Fax
- Phone: 949-591-7280
- Fax: 949-591-7280
- Phone: 949-591-3875
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225A00000X |
| Taxonomy | Music Therapist |
| License Number | 17249 |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: