Provider Demographics
NPI:1295258945
Name:MEYER, ELIZABETH CHRISTINE (AMFT 145488)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:CHRISTINE
Last Name:MEYER
Suffix:
Gender:F
Credentials:AMFT 145488
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2027 E DEODAR ST
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91764-1624
Mailing Address - Country:US
Mailing Address - Phone:909-945-2736
Mailing Address - Fax:
Practice Address - Street 1:2027 E DEODAR ST
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91764-1624
Practice Address - Country:US
Practice Address - Phone:951-427-8316
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-24
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA145488106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist