Basic Information
Provider Information
NPI: 1427145796
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HARPER
FirstName: ELIZABETH
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: PSY.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 7040 AVENIDA ENCINAS
Address2: STE. 104-128
City: CARLSBAD
State: CA
PostalCode: 920114652
CountryCode: US
TelephoneNumber: 6199926588
FaxNumber:  
Practice Location
Address1: 1202 MORENA BLVD STE 300
Address2:  
City: SAN DIEGO
State: CA
PostalCode: 921103844
CountryCode: US
TelephoneNumber: 6192750822
FaxNumber: 6192751422
Other Information
ProviderEnumerationDate: 10/06/2006
LastUpdateDate: 05/18/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
103T00000X  Y Behavioral Health & Social Service ProvidersPsychologist 

No ID Information.


Home