Provider Demographics
NPI:1700151289
Name:ECLARINAL HERRERA, ELAINE ROSE (MA, MFT)
Entity type:Individual
Prefix:
First Name:ELAINE
Middle Name:ROSE
Last Name:ECLARINAL HERRERA
Suffix:
Gender:F
Credentials:MA, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19019 VENTURA BLVD
Mailing Address - Street 2:
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-3253
Mailing Address - Country:US
Mailing Address - Phone:818-345-2345
Mailing Address - Fax:866-587-2383
Practice Address - Street 1:20101 HAMILTON AVE
Practice Address - Street 2:STE 120
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90502-1351
Practice Address - Country:US
Practice Address - Phone:310-527-7300
Practice Address - Fax:310-527-7320
Is Sole Proprietor?:No
Enumeration Date:2012-03-15
Last Update Date:2012-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist