Provider Demographics
NPI:1245324722
Name:PAULA, ELIA (MFT)
Entity type:Individual
Prefix:MS
First Name:ELIA
Middle Name:
Last Name:PAULA
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:431 S PALM CANYON DR STE 214
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92262-7300
Mailing Address - Country:US
Mailing Address - Phone:760-456-8924
Mailing Address - Fax:760-323-3688
Practice Address - Street 1:431 S PALM CANYON DR STE 214
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-7300
Practice Address - Country:US
Practice Address - Phone:760-456-8924
Practice Address - Fax:760-323-3688
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2022-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA44410106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1245324722OtherOUT OF NETWORK