Individual
ADRIAN GABRIEL ELICEGUI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1126 N GRAND AVE, SUITE B, COVINA, CA 91724-1551
(626) 967-1667
Mailing address
1126 N GRAND AVE, SUITE B, COVINA, CA 91724-1551
(626) 967-1667
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
LCSW87914
CA
225400000X
Rehabilitation Practitioner
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
CA
Other
Enumeration date
11/05/2008
Last updated
02/27/2019
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