Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | PSY29511 | CA |
Y | 103T00000X | Psychologist | PSY29511 | CA |
N | 103G00000X | Clinical Psychologist | PSY29511 | CA |
N | 103TC0700X | Clinical Psychologist | PSY29511 | CA |
NPI | 1013340975 |
---|---|
Provider Name | Dr. Erin Elmore |
First Address | La Mesa, CA 91942 |
Second Address | La Mesa, CA 91942 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2013 |
Last Update Date | 15/02/2019 |