Individual
MS. ELIZABETH ANNE PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
250 S G ST, SAN BERNARDINO, CA 92410-3320
(909) 558-1000
Mailing address
250 S G ST, SAN BERNARDINO, CA 92410-3320
(909) 558-1000
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
27404
CA
Other
Enumeration date
03/14/2007
Last updated
05/12/2021
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