Healthcare Provider Details

I. General information

NPI: 1881197770
Provider Name (Legal Business Name): MS. ELIZABETH PAIGE BARHAM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/16/2018
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32107 LINDERO CANYON RD STE 229
WESTLAKE VILLAGE CA
91361-4266
US

IV. Provider business mailing address

32107 LINDERO CANYON RD STE 229
WESTLAKE VILLAGE CA
91361-4266
US

V. Phone/Fax

Practice location:
  • Phone: 818-851-9213
  • Fax: 818-855-7058
Mailing address:
  • Phone: 818-851-9213
  • Fax: 818-855-7058

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-21-52623
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: