Doctor Name: | DR. ROBERT WILLIAM ELLIOTT |
NPI Number: | 1689725574 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PSYCHOLOGIST |
License Number: | 711 |
Business Practice Address: | 5777 W Century Blvd Ste 1645b Los Angeles, CA - 900455696 |
Business Phone Number: | 3105456400 |
Business Fax Number: | 3109397065 |
Mailing Address: | 5777 W Century Blvd Ste 1645b, LOS ANGELES |
State: | CA |
Postal Code: | 900455696 |
Phone Number: | 3105456400 |
Fax Number: | 3109397065 |
NPI Enumeration Date: | 01/16/2007 |
NPI Last Update Date: | 03/28/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103G00000X |
License Number: | 711 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | HI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Clinical Neuropsychologist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |