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NPI Code Detail

MEDICARE: DR. ELENA HERRERA PSY.D.

MEDICARE: DR. ELENA HERRERA PSY.D.
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
1103T00000XPsychologistCA
2103TC2200XClinical Child & Adolescent Psychologist
3103TF0000XFamily Psychologist
4103T00000XPsychologist

General Provider Information

NPI Number : 1558445759
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ELENA HERRERA PSY.D.
Provider Business Mailing Address
First Line : 1040 LINCOLN AVE
Second Line :
City : SAN JOSE
State : CA
Zip : 95125-3150
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1040 LINCOLN AVE
Second Line :
City : SAN JOSE
State : CA
Zip : 95125-3150
Country : US
Telephone Number : 408-290-1555
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/24/2006
Last Update Date : 01/02/2024

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