Provider Demographics
NPI:1538215025
Name:HURST, ELAINE DRAKE (PSYD)
Entity type:Individual
Prefix:DR
First Name:ELAINE
Middle Name:DRAKE
Last Name:HURST
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12125 CORLEY DR
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90604-2927
Mailing Address - Country:US
Mailing Address - Phone:714-423-5150
Mailing Address - Fax:
Practice Address - Street 1:8135 PAINTER AVE
Practice Address - Street 2:SUITE 303
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90602-3102
Practice Address - Country:US
Practice Address - Phone:562-698-8588
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-26
Last Update Date:2010-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY14281103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical