Individual
ELAINE M. EATON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
959 E WALNUT ST, SUITE 212, PASADENA, CA 91106-1451
(310) 551-7120
(626) 796-7765
Mailing address
959 E WALNUT ST, SUITE 212, PASADENA, CA 91106-1451
(310) 551-7120
(626) 796-7765
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY5843
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GK513Z
MEDICARE PTAN
CA
Enumeration date
07/02/2006
Last updated
07/29/2022
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