Provider Demographics
NPI:1538305925
Name:HERZER, ELIZABETH (RAS)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:HERZER
Suffix:
Gender:F
Credentials:RAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2316 BELL EXECUTIVE LN
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-4068
Mailing Address - Country:US
Mailing Address - Phone:916-922-9217
Mailing Address - Fax:916-922-9207
Practice Address - Street 1:2316 BELL EXECUTIVE LN
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-4068
Practice Address - Country:US
Practice Address - Phone:916-922-9217
Practice Address - Fax:916-922-9207
Is Sole Proprietor?:No
Enumeration Date:2009-01-06
Last Update Date:2009-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAH0504101755101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor