Healthcare Provider Details

I. General information

NPI: 1063642767
Provider Name (Legal Business Name): ELOIZA M. ALCARAZ PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/16/2009
Last Update Date: 01/09/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2010 ZONAL AVE
LOS ANGELES CA
90033-1026
US

IV. Provider business mailing address

2010 ZONAL AVE
LOS ANGELES CA
90033-1026
US

V. Phone/Fax

Practice location:
  • Phone: 323-221-4134
  • Fax:
Mailing address:
  • Phone: 323-221-4134
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: