Provider Demographics
NPI:1891480265
Name:MEJIAS CORREA, ELISABETH (PHARMACY TECHNICIAN)
Entity Type:Individual
Prefix:
First Name:ELISABETH
Middle Name:
Last Name:MEJIAS CORREA
Suffix:
Gender:F
Credentials:PHARMACY TECHNICIAN
Other - Prefix:
Other - First Name:ELISABETH
Other - Middle Name:
Other - Last Name:MEJIAS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:11716 GURLEY AVE APT 14
Mailing Address - Street 2:
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90241-4834
Mailing Address - Country:US
Mailing Address - Phone:562-650-3179
Mailing Address - Fax:
Practice Address - Street 1:11716 GURLEY AVE APT 14
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90241-4834
Practice Address - Country:US
Practice Address - Phone:562-650-3179
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-10
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101YP1600X
101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral