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General NPI Number Information
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NPI Number | 1902266745
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Entity Type | Individual
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Provider Name | HALA R. ELSHIWICK M.A.
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Gender | Female
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Dates
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Enumeration Date | 03/04/2016
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Last Update Date | 11/07/2016
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Provider Practice Location Address
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Address Line | 23181 LA CADENA DR STE 104
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City | LAGUNA HILLS
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State | CA
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Zip | 92653-1479
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Country | US
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Telephone | 949-954-8029
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3794
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City | MISSION VIEJO
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State | CA
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Zip | 92690-3794
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Country | US
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Telephone |
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 91249
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License Number State | CA
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