Provider Demographics
NPI:1972710747
Name:DEETHS, ELIZABETH ANN (LMFT)
Entity type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:ANN
Last Name:DEETHS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5401 BUSINESS PARK S
Mailing Address - Street 2:SUITE 208
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-0721
Mailing Address - Country:US
Mailing Address - Phone:661-889-4638
Mailing Address - Fax:661-748-1910
Practice Address - Street 1:5401 BUSINESS PARK S
Practice Address - Street 2:SUITE 208
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-0721
Practice Address - Country:US
Practice Address - Phone:661-889-4638
Practice Address - Fax:661-748-1910
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2013-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 45346106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist