Provider Demographics
NPI:1114246014
Name:ELFERS, JOHN P (PHD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:P
Last Name:ELFERS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2494 PENNINGTON CREEK RD
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93405-7841
Mailing Address - Country:US
Mailing Address - Phone:805-782-7340
Mailing Address - Fax:805-543-2599
Practice Address - Street 1:2494 PENNINGTON CREEK RD
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93405-7841
Practice Address - Country:US
Practice Address - Phone:805-782-7340
Practice Address - Fax:805-543-2599
Is Sole Proprietor?:No
Enumeration Date:2010-05-18
Last Update Date:2010-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC32786106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist