Individual
DR. CAROL MARIE ELIAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
2001 N GAREY AVE, STE. 107, POMONA, CA 91767-2773
(909) 622-0148
(909) 622-7101
Mailing address
2001 N GAREY AVE, STE. 107, POMONA, CA 91767-2773
(909) 622-0148
(909) 622-7101
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY 16418
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1730035
FIRST HEALTH
CA
01
—
208817
MANAGED HEALTH NETWORK
CA
01
—
407529
VALUE OPTIONS
CA
01
—
61-95987
US BEHAVIORAL HEALTH PLAN
CA
01
—
OPL 164180
BLUE SHIELD
CA
05
—
PSY164180
—
CA
Enumeration date
12/12/2006
Last updated
07/09/2007
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