Individual
DR. ELIZABETH SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
5199 E PACIFIC COAST HWY STE 612, LONG BEACH, CA 90804-3366
(213) 437-3569
Mailing address
642 N HAYWORTH AVE APT 9, LOS ANGELES, CA 90048-2339
(312) 330-3845
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY28723
CA
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
11/28/2005
Last updated
12/03/2019
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