Provider Demographics
NPI:1720170749
Name:JEW, ELIZABETH VIOLET (ASW, MSW)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:VIOLET
Last Name:JEW
Suffix:
Gender:F
Credentials:ASW, MSW
Other - Prefix:MS
Other - First Name:VIOLET
Other - Middle Name:ELLEN
Other - Last Name:WANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1588 SAPPHIRE DR
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92011-1230
Mailing Address - Country:US
Mailing Address - Phone:760-438-4549
Mailing Address - Fax:
Practice Address - Street 1:405 W 5TH ST
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92701-4519
Practice Address - Country:US
Practice Address - Phone:714-834-4707
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health