Provider Demographics
NPI:1376947812
Name:HAMALA, ELITA (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:ELITA
Middle Name:
Last Name:HAMALA
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:MRS
Other - First Name:ELITA
Other - Middle Name:
Other - Last Name:SHALKEVICH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMFT
Mailing Address - Street 1:23679 CALABASAS RD # 645
Mailing Address - Street 2:
Mailing Address - City:CALABASAS
Mailing Address - State:CA
Mailing Address - Zip Code:91302-1502
Mailing Address - Country:US
Mailing Address - Phone:818-472-6009
Mailing Address - Fax:
Practice Address - Street 1:9036 RESEDA BLVD
Practice Address - Street 2:SUITE 204
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91324-3929
Practice Address - Country:US
Practice Address - Phone:818-472-6009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-13
Last Update Date:2014-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC51135106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist