Provider Demographics
NPI:1588845093
Name:VAZQUEZ, ELVIA
Entity Type:Individual
Prefix:
First Name:ELVIA
Middle Name:
Last Name:VAZQUEZ
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 1:26413 JEFFERSON AVE
Mailing Address - Street 2:H
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-6979
Mailing Address - Country:US
Mailing Address - Phone:951-677-7900
Mailing Address - Fax:951-677-6877
Practice Address - Street 1:26413 JEFFERSON AVE
Practice Address - Street 2:H
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-6979
Practice Address - Country:US
Practice Address - Phone:951-677-7900
Practice Address - Fax:951-677-6877
Is Sole Proprietor?:No
Enumeration Date:2007-11-27
Last Update Date:2007-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health