Provider Demographics
NPI:1194437780
Name:TOBIAS, ELIZABETH U
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:U
Last Name:TOBIAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15532 CABAZON ST
Mailing Address - Street 2:
Mailing Address - City:VICTORVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:92395-5507
Mailing Address - Country:US
Mailing Address - Phone:760-713-5612
Mailing Address - Fax:
Practice Address - Street 1:15532 CABAZON ST
Practice Address - Street 2:
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92395-5507
Practice Address - Country:US
Practice Address - Phone:760-713-5612
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-15
Last Update Date:2022-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst