Individual
MS. ELISABETH CHERYL FLETCHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA CCC
Contact information
Practice address
150 VALLEY VISTA DR, CAMARILLO, CA 93010-1725
(805) 484-1671
(805) 987-0667
Mailing address
150 VALLEY VISTA DR, CAMARILLO, CA 93010-1725
(805) 484-1671
(805) 987-0667
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
1-11-8110
—
235Z00000X
Speech-Language Pathologist
Primary
SP 3002
CA
252Y00000X
Early Intervention Provider Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ83857Z
BLUE SHIELD
CA
Enumeration date
01/02/2007
Last updated
06/17/2013
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