Basic Information
| Provider Information | |||||||||
| NPI: | 1538651765 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ELORZA | ||||||||
| FirstName: | MARRAH | ||||||||
| MiddleName: | D. Z. | ||||||||
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| Credential: | PSY. D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3360 N SAN FERNANDO RD # 1004 | ||||||||
| Address2: | |||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900651417 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2134798131 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3756 SANTA ROSALIA DR | ||||||||
| Address2: | |||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900083606 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3232938771 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/04/2018 | ||||||||
| LastUpdateDate: | 06/01/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 06/01/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103T00000X | PSY32628 | CA | Y | Behavioral Health & Social Service Providers | Psychologist |
No ID Information.