Provider Demographics
NPI:1841688009
Name:CARCIERI, ELISHA MITCHELL (PHD)
Entity type:Individual
Prefix:DR
First Name:ELISHA
Middle Name:MITCHELL
Last Name:CARCIERI
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11812 SAN VICENTE BLVD FL 4
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90049-6625
Mailing Address - Country:US
Mailing Address - Phone:505-453-7954
Mailing Address - Fax:
Practice Address - Street 1:4929 WILSHIRE BLVD STE 1000
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90010-3825
Practice Address - Country:US
Practice Address - Phone:323-282-3572
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-22
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA26716103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical