Provider Demographics
NPI:1417185406
Name:ECKERBERG, HELENA (PHD)
Entity Type:Individual
Prefix:
First Name:HELENA
Middle Name:
Last Name:ECKERBERG
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3784 MISSION AVE STE 148
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92058-1460
Mailing Address - Country:US
Mailing Address - Phone:650-814-1454
Mailing Address - Fax:
Practice Address - Street 1:5425 OBERLIN DR STE 105
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-1703
Practice Address - Country:US
Practice Address - Phone:650-814-1454
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-29
Last Update Date:2021-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY16856103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist