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NPI Code Detail

MEDICARE: TRISHA ELLOYAN

MEDICARE:   TRISHA  ELLOYAN
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
1103T00000XPsychologist

General Provider Information

NPI Number : 1578976668
Entity Type Code : Individual
Provider Name (Legal Business Name) : TRISHA ELLOYAN
Provider Business Mailing Address
First Line : 8202 TERRY DR
Second Line :
City : HUNTINGTON BEACH
State : CA
Zip : 92647-4826
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 8202 TERRY DR
Second Line :
City : HUNTINGTON BEACH
State : CA
Zip : 92647-4826
Country : US
Telephone Number : 775-671-5302
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/05/2014
Last Update Date : 06/05/2014

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Directions to “ TRISHA ELLOYAN ” Practice Location

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