MEDICARE: ELIZABETH COLEY CROUPPEN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	SP15498	CA

General Provider Information

NPI Number	:	1134064348
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH COLEY CROUPPEN

Provider Business Mailing Address
First Line	:	1442 W SUNSET BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90026-3432
Country	:	US
Telephone Number	:	323-823-6659
Fax Number	:

Provider Business Practice Location Address
First Line	:	1442 W SUNSET BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90026-3432
Country	:	US
Telephone Number	:	323-823-6659
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/22/2026
Last Update Date	:	04/22/2026

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Directions to “ ELIZABETH COLEY CROUPPEN ” Practice Location

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