| Elsa Matsumoto Licensed Clinical Social Worker Inc. | |
|
1317 W Foothill Blvd Ste 226 Upland CA 91786-3673 | |
| (626) 209-9965 | |
| Not Available |
| Full Name | Elsa Matsumoto Licensed Clinical Social Worker Inc. |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1317 W Foothill Blvd Ste 226, Upland, California |
| Authorized Official Name and Position | Elsa Matsumoto (LICENSED CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 6262099965 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Elsa Matsumoto Licensed Clinical Social Worker Inc. Po Box 1064 Duarte CA 91009-4064 Ph: (626) 209-9965 | Elsa Matsumoto Licensed Clinical Social Worker Inc. 1317 W Foothill Blvd Ste 226 Upland CA 91786-3673 Ph: (626) 209-9965 |
| NPI Number | 1851014542 |
|---|---|
| Provider Enumeration Date | 09/19/2022 |
| Last Update Date | 09/19/2022 |
| Certification Date | 09/19/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851014542 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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