Provider Demographics
NPI:1962033423
Name:ARTEAGA, ELIZABETH HERRERA
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:HERRERA
Last Name:ARTEAGA
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 1:8510 BALBOA BLVD STE 150
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91325-5810
Mailing Address - Country:US
Mailing Address - Phone:818-654-3400
Mailing Address - Fax:
Practice Address - Street 1:600 CITY PKWY W STE 400
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-2900
Practice Address - Country:US
Practice Address - Phone:714-908-5600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-03
Last Update Date:2020-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA815651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical