Elias, Carol Marie

Elias, Carol Marie is an sole proprietor health care provider with primary practice located at 2001 N Garey Ave Ste. 107, Pomona CA 91767-2773. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Elias, Carol Marie can be contacted via phone (909) 622-0148.

Contact Information

Primary practice address
2001 N Garey Ave Ste. 107 Pomona CA 91767-2773
Phone: (909) 622-0148
Fax: (909) 622-7101
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X PSY 16418 California

Profile Details

NPI number 1730249384
LBN Legal business name Elias, Carol Marie
Credentials PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 12th, 2006
Last updated Jul 9th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1730249384 NPPES
California Other OPL 164180 BLUE SHIELD
California Other 1730035 BLUE SHIELD
California Other 208817 BLUE SHIELD
California Other 61-95987 BLUE SHIELD
California Other 407529 BLUE SHIELD
California MEDICAID PSY164180 BLUE SHIELD

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