Provider Demographics
NPI:1740397967
Name:LASHURE, ELIZABETH TEWIS (MSW LCSW)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:TEWIS
Last Name:LASHURE
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Gender:F
Credentials:MSW LCSW
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Mailing Address - Street 1:2525 CAMINO DEL RIO S
Mailing Address - Street 2:#305
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-3717
Mailing Address - Country:US
Mailing Address - Phone:619-491-0438
Mailing Address - Fax:619-491-0011
Practice Address - Street 1:2525 CAMINO DEL RIO S
Practice Address - Street 2:#305
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-3717
Practice Address - Country:US
Practice Address - Phone:619-491-0438
Practice Address - Fax:619-491-0011
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2010-11-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CALCS75201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW13604Medicare UPIN