Healthcare Provider Details
I. General information
NPI: 1124837513
Provider Name (Legal Business Name): ELAINA MARIE-YVETTE CARTAGENA NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 12/31/2024
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1921 S CATALINA AVE STE 1
REDONDO BEACH CA
90277-5516
US
IV. Provider business mailing address
20832 VALERIO ST UNIT 7
WINNETKA CA
91306-2789
US
V. Phone/Fax
- Phone: 562-451-9456
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 163WP0808X |
| Taxonomy | Psychiatric/Mental Health Registered Nurse |
| License Number | 2024087422 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: