Individual
ROY ALLAN O ELEVAZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PMHNP-BC
Contact information
Practice address
5220 CLARK AVE STE 400, LAKEWOOD, CA 90712-2625
(562) 804-3575
(562) 286-8123
Mailing address
3553 ATLANTIC AVENUE #253, LONG BEACH, CA 90807
(562) 804-3575
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95000309
CA
Other
Enumeration date
12/02/2013
Last updated
10/16/2024
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