Active NPI
Unknown Eloecea
- Clinical Psychologist
- Sun Valley, CA
National Provider Identifier
1396780508
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY12376
- Practice address
- 8365 La Tuna Canyon Rd # B
Sun Valley, CA 91352-2242 - Phone
- (818) 446-0507
- Fax
- (818) 446-0502
- NPI assigned
- Jun 19, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY12376 | CA | Primary |
Addresses
Primary practice location
8365 La Tuna Canyon Rd # B
Sun Valley, CA 91352-2242
Mailing address
8365 La Tuna Canyon Rd # B
Sun Valley, CA 91352-2242
Phone (818) 446-0507
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY12376 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150675200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1218758400000",
"number": "1396780508",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8365 LA TUNA CANYON RD # B",
"city": "SUN VALLEY",
"state": "CA",
"postal_code": "913522242",
"telephone_number": "818-446-0507",
"fax_number": "818-446-0502"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8365 LA TUNA CANYON RD # B",
"city": "SUN VALLEY",
"state": "CA",
"postal_code": "913522242",
"telephone_number": "818-446-0507",
"fax_number": "818-446-0502"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELOECEA",
"first_name": "UNKNOWN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-19",
"last_updated": "2008-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY12376",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sun Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.