Elisha Bacon
Individual provider Active NPI Marriage & Family Therapist · Santa Fe Springs, CA
NPI 1124525316 · NPPES record last updated Apr 12, 2018
Key facts
- NPI
- 1124525316
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- Practice address
- 11015 Bloomfield Ave
Santa Fe Springs, CA 90670-4601 - Phone
- (562) 906-2676
- NPI assigned
- Apr 12, 2018
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Los Angeles County Department of Public Health | Current | Accepting new patients |
Interoperability endpoints
- elishabacon-lacada@lacsapc.netsmartdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | Yes |
Addresses
Primary practice location
11015 Bloomfield Ave
Santa Fe Springs, CA 90670-4601
Mailing address
11015 Bloomfield Ave
Santa Fe Springs, CA 90670-4601
Phone (562) 906-2676
Other providers in Santa Fe Springs, CA
- Samantha Atwood
- Blanca L Avalos-Diaz
- David Ari Avelar
- Jorge Luis Avila Jr.
- Vickie Acelia Ventura Avila
- Dania Jamal Badawi
- Rebecca Baer
- Ken Bagnis
- Seungbum Bak
- Jolene-Fe Caguicla Balancio
All providers in Santa Fe Springs, CA · Marriage & Family Therapist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 12, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.