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Individual

ELIZABETH DE LA PENA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1333 ISLAND AVE, WILMINGTON, CA 90744-2501
(310) 850-5857
Mailing address
1333 ISLAND AVE, WILMINGTON, CA 90744-2501

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSB94022632
CA

Other

Enumeration date
02/02/2018
Last updated
02/02/2018
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