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General NPI Number Information
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NPI Number | 1639200306
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Entity Type | Individual
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Provider Name | ELAINE J.H. TERAN I.M.F.T.
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Gender | Female
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Dates
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Enumeration Date | 03/07/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1701 CAMINO PALMERO ST
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City | LOS ANGELES
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State | CA
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Zip | 90046-2902
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Country | US
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Telephone | 323-876-0550
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Fax | 323-876-0439
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Provider Business Mailing Address
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Address Line | 4623 W 137TH PL
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City | HAWTHORNE
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State | CA
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Zip | 90250-6805
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Country | US
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Telephone | 310-675-5436
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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