Individual
ELIZABETH PETRISCA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
1000 GOODRICH BLVD, COMMERCE, CA 90022
(213) 832-9795
Mailing address
1000 GOODRICH BLVD, COMMERCE, CA 90022-5103
(213) 832-9795
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
103TC0700X
Clinical Psychologist
Primary
PSY30521
CA
225400000X
Rehabilitation Practitioner
—
—
225C00000X
Rehabilitation Counselor
—
—
Other
Enumeration date
09/12/2011
Last updated
02/23/2024
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