MEDICARE: ELIZABETH DI FRANCISCO PSYD

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	103T00000X	Psychologist	3819	TN
2	103T00000X	Psychologist	3294	OR

General Provider Information

NPI Number	:	1184136756
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH DI FRANCISCO PSYD

Provider Business Mailing Address
First Line	:	6288 RIVOLI DR APT 105
Second Line	:
City	:	HIXSON
State	:	TN
Zip	:	37343-0079
Country	:	US
Telephone Number	:	971-570-7311
Fax Number	:

Provider Business Practice Location Address
First Line	:	4800 S MACADAM AVE STE 230
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97239-3927
Country	:	US
Telephone Number	:	877-840-6956
Fax Number	:	619-383-6701

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

Provider Enumeration Date	:	11/03/2017
Last Update Date	:	09/30/2024

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