Provider Demographics
NPI:1326577693
Name:HARRISON, ELEANOR
Entity Type:Individual
Prefix:MS
First Name:ELEANOR
Middle Name:
Last Name:HARRISON
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 1:40555 177TH ST E
Mailing Address - Street 2:
Mailing Address - City:LAKE LA
Mailing Address - State:CA
Mailing Address - Zip Code:93535-7506
Mailing Address - Country:US
Mailing Address - Phone:626-348-4579
Mailing Address - Fax:
Practice Address - Street 1:40555 177TH ST. EAST
Practice Address - Street 2:
Practice Address - City:LAKE L.A.
Practice Address - State:CA
Practice Address - Zip Code:93535-7506
Practice Address - Country:US
Practice Address - Phone:626-348-4579
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)