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NPI Code Detail

MEDICARE: ELIZABETH ELDER L.C.S.W.

MEDICARE: ELIZABETH ELDER L.C.S.W.
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
11041C0700XClinical Social Worker22898CA

General Provider Information

NPI Number : 1295899938
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH ELDER L.C.S.W.
Provider Business Mailing Address
First Line : 323 CANAL WAY
Second Line :
City : COSTA MESA
State : CA
Zip : 92627-2292
Country : US
Telephone Number : 714-878-9726
Fax Number :
Provider Business Practice Location Address
First Line : 18600 MAIN ST STE 295
Second Line :
City : HUNTINGTON BEACH
State : CA
Zip : 92648-1728
Country : US
Telephone Number : 714-878-9796
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/20/2006
Last Update Date : 12/10/2025

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