Provider Information for 1356523005
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Mr. ELIAS PROTOPSALTIS MFT
Sex: Male
NPI: 1356523005
Last Updated: 2013-12-12
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1356523005 | ||||||||
| Enumeration Date | 2007-12-04 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 945 KAROL WAY SAN LEANDRO, CA 94577-3744 United States Phone: 510-909-4296 | Fax: | ||||||||
| Primary Practice Address | 945 KAROL WAY SAN LEANDRO, CA 94577-3744 United States Phone: 510-909-4296 | Fax: | ||||||||
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