Individual
ELISA FAJARDO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
20 CENTERPOINTE DR STE 130, LA PALMA, CA 90623-2562
(657) 325-8313
Mailing address
20 CENTERPOINTE DR STE 130, LA PALMA, CA 90623-2562
(657) 325-8313
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
MPSS-KHTXAD
CA
Other
Enumeration date
04/27/2026
Last updated
04/27/2026
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