Basic Information
| Provider Information | |||||||||
| NPI: | 1205966793 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ELDER | ||||||||
| FirstName: | JULIE | ||||||||
| MiddleName: | |||||||||
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| Credential: | MSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2515 MAGNOLIA AVE | ||||||||
| Address2: | |||||||||
| City: | LONG BEACH | ||||||||
| State: | CA | ||||||||
| PostalCode: | 908062816 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5625772236 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2610 INDUSTRY WAY | ||||||||
| Address2: | SUITE A | ||||||||
| City: | LYNWOOD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 902624028 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3106318004 | ||||||||
| FaxNumber: | 3106315875 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/06/2007 | ||||||||
| LastUpdateDate: | 07/21/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/21/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.