Provider Demographics
NPI:1306870373
Name:ELSTER, PATRICE S (PHD)
Entity type:Individual
Prefix:DR
First Name:PATRICE
Middle Name:S
Last Name:ELSTER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:806 MANHATTAN BEACH BLVD STE 207
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90266-4961
Mailing Address - Country:US
Mailing Address - Phone:310-376-3388
Mailing Address - Fax:310-545-0772
Practice Address - Street 1:806 MANHATTAN BEACH BLVD STE 207
Practice Address - Street 2:
Practice Address - City:MANHATTAN BEACH
Practice Address - State:CA
Practice Address - Zip Code:90266-4961
Practice Address - Country:US
Practice Address - Phone:310-376-3388
Practice Address - Fax:310-545-0772
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY12613103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACP12613Medicare ID - Type UnspecifiedPSYCHOLOGIST MEDICARE