Provider Demographics
NPI:1003666751
Name:SETER, ELIZABETH THERESE
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:THERESE
Last Name:SETER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1461 FORD ST STE 202
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92373-3909
Mailing Address - Country:US
Mailing Address - Phone:909-792-5551
Mailing Address - Fax:
Practice Address - Street 1:201 BROOKSIDE AVE UNIT 110
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92373-2505
Practice Address - Country:US
Practice Address - Phone:909-792-5551
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-25
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA133357101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health