Provider Demographics
NPI:1467664185
Name:PLUMMER, ELIZABETH P (PHD)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:P
Last Name:PLUMMER
Suffix:
Gender:
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13561 N PLACITA MONTANAS DE ORO
Mailing Address - Street 2:
Mailing Address - City:ORO VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85755
Mailing Address - Country:US
Mailing Address - Phone:805-455-7202
Mailing Address - Fax:
Practice Address - Street 1:13561 N PLACITA MONTANAS DE ORO
Practice Address - Street 2:
Practice Address - City:ORO VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85755
Practice Address - Country:US
Practice Address - Phone:805-455-7202
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0675240OtherMEDI-CAL
CA42ABMedicaid
BQ829AOtherMEDICARE PTAN
CA42ABMedicaid
CACP19690Medicare PIN