| Doctor Name: | ELIZABETH BARBARA WILLERUP |
| NPI Number: | 1003801820 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RNP |
| License Number: | 318629 |
| Business Practice Address: | 1643 Eureka Rd Roseville, CA - 956613027 |
| Business Phone Number: | 9167717627 |
| Business Fax Number: | 9167717650 |
| Mailing Address: | 1643 Eureka Rd, ROSEVILLE |
| State: | CA |
| Postal Code: | 956613027 |
| Phone Number: | 9167717627 |
| Fax Number: | 9167717650 |
| NPI Enumeration Date: | 09/19/2005 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0808X |
| License Number: | 318629 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |