Healthcare Provider Details

I. General information

NPI: 1821577081
Provider Name (Legal Business Name): ELIZABETH KATHERINE WEISENBURGER LPCC 23097
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/08/2018
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 WEST WASHINGTON STREET, SUITE 2 #3015
SAN DIEGO CA
92103-1946
US

IV. Provider business mailing address

1303 W LEWIS ST APT 3
SAN DIEGO CA
92103-1755
US

V. Phone/Fax

Practice location:
  • Phone: 619-604-5258
  • Fax:
Mailing address:
  • Phone: 805-403-4289
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number23097
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: