Provider Demographics
NPI:1790375285
Name:TAKOUNAKIS, ELENA
Entity Type:Individual
Prefix:
First Name:ELENA
Middle Name:
Last Name:TAKOUNAKIS
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 1:451 W LAMBERT RD STE 212
Mailing Address - Street 2:
Mailing Address - City:BREA
Mailing Address - State:CA
Mailing Address - Zip Code:92821-3920
Mailing Address - Country:US
Mailing Address - Phone:949-294-6249
Mailing Address - Fax:
Practice Address - Street 1:451 W LAMBERT RD
Practice Address - Street 2:
Practice Address - City:BREA
Practice Address - State:CA
Practice Address - Zip Code:92821-3922
Practice Address - Country:US
Practice Address - Phone:714-276-7871
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-19
Last Update Date:2021-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor