Doctor Name: | JENNIFER NICOLE ELIAS |
NPI Number: | 1104152818 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 410 E 7th St Hanford, CA - 932304606 |
Business Phone Number: | 5595848100 |
Business Fax Number: | 5595852008 |
Mailing Address: | 2047 Carter Way, HANFORD |
State: | CA |
Postal Code: | 932301738 |
Phone Number: | 6615868131 |
Fax Number: | |
NPI Enumeration Date: | 10/30/2009 |
NPI Last Update Date: | 10/30/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |