Provider Information for 1508530064
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Dr. HELEN ELIZABETH ANTONIAK Ph.D.
Sex: Female
NPI: 1508530064
Last Updated: 2021-08-06
Certification Date: 2021-08-04
Certification Date: 2021-08-04
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1508530064 | ||||||||
| Enumeration Date | 2021-08-06 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 1528 MONITOR RD SAN DIEGO, CA 92110-1547 United States Phone: 619-817-6858 | Fax: | ||||||||
| Primary Practice Address | 1528 MONITOR RD SAN DIEGO, CA 92110-1547 United States Phone: 619-817-6858 | Fax: | ||||||||
| Secondary Practice Address(es) | 1528 MONITOR RD | ||||||||
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