Healthcare Provider Details

I. General information

NPI: 1518877521
Provider Name (Legal Business Name): ELYSSE RHODES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/10/2026
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 570106
TARZANA CA
91357-0106
US

IV. Provider business mailing address

PO BOX 570106
TARZANA CA
91357-0106
US

V. Phone/Fax

Practice location:
  • Phone: 424-234-1426
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: