Provider Demographics
NPI:1083782452
Name:ELIAZAR, ANGELICA CAUSOR (MSW)
Entity Type:Individual
Prefix:MRS
First Name:ANGELICA
Middle Name:CAUSOR
Last Name:ELIAZAR
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MS
Other - First Name:ANGELICA
Other - Middle Name:MARIA
Other - Last Name:CAUSOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:160 E VIRGINIA ST
Mailing Address - Street 2:SAN JOSE
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95112-5857
Mailing Address - Country:US
Mailing Address - Phone:408-287-6200
Mailing Address - Fax:
Practice Address - Street 1:160 E VIRGINIA STE 280
Practice Address - Street 2:SAN JOSE
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95112
Practice Address - Country:US
Practice Address - Phone:408-287-6200
Practice Address - Fax:408-998-1535
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health