Provider Demographics
NPI:1801862347
Name:MCELIECE, C JEANNETTE (RN,MFT)
Entity Type:Individual
Prefix:MS
First Name:C
Middle Name:JEANNETTE
Last Name:MCELIECE
Suffix:
Gender:F
Credentials:RN,MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:993 E CALIFORNIA BLVD
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91106-4046
Mailing Address - Country:US
Mailing Address - Phone:626-577-8169
Mailing Address - Fax:
Practice Address - Street 1:70 S PALM AVE
Practice Address - Street 2:
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91801-3101
Practice Address - Country:US
Practice Address - Phone:626-570-9003
Practice Address - Fax:626-570-9026
Is Sole Proprietor?:No
Enumeration Date:2006-02-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 29148101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health