Provider Demographics
NPI:1710202957
Name:MARUSHIN, ELIZABETH H (MFT)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:H
Last Name:MARUSHIN
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3201 PACIFIC COAST HWY
Mailing Address - Street 2:SUITE C
Mailing Address - City:HERMOSA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90254-2200
Mailing Address - Country:US
Mailing Address - Phone:310-987-9511
Mailing Address - Fax:310-372-0117
Practice Address - Street 1:3201 PACIFIC COAST HWY
Practice Address - Street 2:SUITE C
Practice Address - City:HERMOSA BEACH
Practice Address - State:CA
Practice Address - Zip Code:90254-2200
Practice Address - Country:US
Practice Address - Phone:310-987-9511
Practice Address - Fax:310-372-0117
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-31
Last Update Date:2010-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 48097106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist