Individual
EUGENA COURTNEY ELLIOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9449 LAGUNA POINTE WAY, ELK GROVE, CA 95758-4079
(510) 776-2513
Mailing address
9449 LAGUNA POINTE WAY, ELK GROVE, CA 95758-4079
(510) 776-2513
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40555
—
CA
Enumeration date
02/14/2022
Last updated
02/24/2022
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