Provider Demographics
NPI:1952408973
Name:MILNES, ELIZABETH E (PSYD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:E
Last Name:MILNES
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2719 ENCINAL AVE STE D
Mailing Address - Street 2:
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501-4773
Mailing Address - Country:US
Mailing Address - Phone:510-759-3774
Mailing Address - Fax:
Practice Address - Street 1:2719 ENCINAL AVE STE D
Practice Address - Street 2:
Practice Address - City:ALAMEDA
Practice Address - State:CA
Practice Address - Zip Code:94501-4773
Practice Address - Country:US
Practice Address - Phone:510-759-3774
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12525103TC0700X
CACAPSY12525103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA125250Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER