Provider Demographics
NPI:1609635390
Name:SCANLAN, ELOISA MARGARITA (MSN,PMHNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:ELOISA
Middle Name:MARGARITA
Last Name:SCANLAN
Suffix:
Gender:F
Credentials:MSN,PMHNP-BC
Other - Prefix:
Other - First Name:ELOISA
Other - Middle Name:MARGARITA
Other - Last Name:GARCIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:28062 BAXTER RD
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92563-1401
Mailing Address - Country:US
Mailing Address - Phone:951-290-4000
Mailing Address - Fax:
Practice Address - Street 1:28062 BAXTER RD
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92563-1401
Practice Address - Country:US
Practice Address - Phone:951-290-4000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-15
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ273093163W00000X
CA95161417163WC0400X
CA2023208771363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
No163WC0400XNursing Service ProvidersRegistered NurseCase ManagementGroup - Multi-Specialty