Provider Demographics
NPI:1588378996
Name:WEIL, ELISHEVA MALKA (MSW)
Entity type:Individual
Prefix:
First Name:ELISHEVA
Middle Name:MALKA
Last Name:WEIL
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1454 S CREST DR
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90035-3312
Mailing Address - Country:US
Mailing Address - Phone:310-435-1775
Mailing Address - Fax:
Practice Address - Street 1:444 N LARCHMONT BLVD STE 102
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90004-3030
Practice Address - Country:US
Practice Address - Phone:310-435-1775
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-10
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty