Provider Demographics
NPI:1255649786
Name:CORDES, ELIZABETH THELMA (PHD, LMFT, JD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:THELMA
Last Name:CORDES
Suffix:
Gender:F
Credentials:PHD, LMFT, JD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27001 LA PAZ RD STE AB
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-5502
Mailing Address - Country:US
Mailing Address - Phone:949-380-1717
Mailing Address - Fax:949-380-1718
Practice Address - Street 1:27001 LA PAZ RD STE AB
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-5502
Practice Address - Country:US
Practice Address - Phone:949-380-1717
Practice Address - Fax:949-380-1718
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-17
Last Update Date:2010-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA41960106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist