Elisha Bacon
Marriage & Family Therapist in Santa Fe Springs, CA. Individual provider (NPI-1).
NPI number1124525316
StatusActive
Last updated in NPPESApr 12, 2018
Details
- NPI
- 1124525316
- Entity type
- Individual (NPI-1)
- Name
- Elisha Bacon
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Apr 12, 2018
- Last updated
- Apr 12, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | – | – | Yes |
Practice location
11015 Bloomfield AveSanta Fe Springs, CA 90670-4601
Phone 562-906-2676
Mailing address
11015 Bloomfield AveSanta Fe Springs, CA 90670-4601
Phone 562-906-2676
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