Healthcare Provider Details

I. General information

NPI: 1952275265
Provider Name (Legal Business Name): ELIZABETH LLAMAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2025
Last Update Date: 09/30/2025
Certification Date: 09/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 CALIFORNIA AVE APT 105
SIGNAL HILL CA
90755-3300
US

IV. Provider business mailing address

2400 CALIFORNIA AVE APT 105
SIGNAL HILL CA
90755-3300
US

V. Phone/Fax

Practice location:
  • Phone: 562-424-6105
  • Fax:
Mailing address:
  • Phone: 562-424-6105
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberSUDRC17995
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: