MEDICARE: LUZ ELIANA PRECIADO

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1225343668
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LUZ ELIANA PRECIADO

Provider Business Mailing Address
First Line	:	5638 HOLLISTER AVE
Second Line	:	SUITE 230
City	:	GOLETA
State	:	CA
Zip	:	93117-3474
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5638 HOLLISTER AVE
Second Line	:	SUITE 230
City	:	GOLETA
State	:	CA
Zip	:	93117-3474
Country	:	US
Telephone Number	:	805-964-8857
Fax Number	:

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

Provider Enumeration Date	:	08/10/2010
Last Update Date	:	08/10/2010

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