Provider Demographics
NPI:1639200306
Name:TERAN, ELAINE JH (IMFT)
Entity Type:Individual
Prefix:MS
First Name:ELAINE
Middle Name:JH
Last Name:TERAN
Suffix:
Gender:F
Credentials:IMFT
Other - Prefix:MS
Other - First Name:ELAINE
Other - Middle Name:J
Other - Last Name:HESS-TERAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4623 W 137TH PL
Mailing Address - Street 2:
Mailing Address - City:HAWTHORNE
Mailing Address - State:CA
Mailing Address - Zip Code:90250-6805
Mailing Address - Country:US
Mailing Address - Phone:310-675-5436
Mailing Address - Fax:
Practice Address - Street 1:1701 CAMINO PALMERO ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90046-2902
Practice Address - Country:US
Practice Address - Phone:323-876-0550
Practice Address - Fax:323-876-0439
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator