Provider Demographics
NPI:1780989327
Name:GOLD MICHAELS, ELENA (PHD MFT)
Entity type:Individual
Prefix:DR
First Name:ELENA
Middle Name:
Last Name:GOLD MICHAELS
Suffix:
Gender:F
Credentials:PHD MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28005 SMYTH DR
Mailing Address - Street 2:SUITE # 107
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-4023
Mailing Address - Country:US
Mailing Address - Phone:661-250-4395
Mailing Address - Fax:
Practice Address - Street 1:28005 SMYTH DR
Practice Address - Street 2:SUITE # 107
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-4023
Practice Address - Country:US
Practice Address - Phone:661-250-4395
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-12
Last Update Date:2011-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33041106H00000X
133N00000X, 175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No133N00000XDietary & Nutritional Service ProvidersNutritionist
No175F00000XOther Service ProvidersNaturopath