Provider Demographics
NPI:1043074966
Name:BEENHOUWER, ELIZA LU
Entity Type:Individual
Prefix:
First Name:ELIZA
Middle Name:LU
Last Name:BEENHOUWER
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 1:3134 1/2 ARVIA ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90065-1802
Mailing Address - Country:US
Mailing Address - Phone:424-256-6968
Mailing Address - Fax:
Practice Address - Street 1:4221 WILSHIRE BLVD STE 320
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90010-3559
Practice Address - Country:US
Practice Address - Phone:424-256-6968
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-12
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA144601106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist