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NPI Code Detail

MEDICARE: ELIZABETH THELEN

MEDICARE: ELIZABETH THELEN
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 WorkerASW132647CA

General Provider Information

NPI Number : 1831042191
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH THELEN
Provider Business Mailing Address
First Line : 350 S FULLER AVE APT 6D
Second Line :
City : LOS ANGELES
State : CA
Zip : 90036-5584
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1230 ROSECRANS AVE STE 300
Second Line :
City : MANHATTAN BEACH
State : CA
Zip : 90266-2494
Country : US
Telephone Number : 424-903-6520
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/17/2026
Last Update Date : 02/17/2026

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Directions to “ ELIZABETH THELEN ” Practice Location

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