Doctor Name: | DEBRA ELLIS |
NPI Number: | 1780090340 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | PT18954 |
Business Practice Address: | 7340 Kilborn Dr Fair Oaks, CA - 956283336 |
Business Phone Number: | 7074842276 |
Business Fax Number: | 9169747851 |
Mailing Address: | 7340 Kilborn Dr, FAIR OAKS |
State: | CA |
Postal Code: | 956283336 |
Phone Number: | 7074842276 |
Fax Number: | 9169747851 |
NPI Enumeration Date: | 07/03/2014 |
NPI Last Update Date: | 07/03/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | PT18954 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |