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Organization
STEPHANIE ELLIS, LICENSED CLINICAL SOCIAL WORKER, P.C.
Active
Organization
STEPHANIE ELLIS, LICENSED CLINICAL SOCIAL WORKER, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANA D ELLIS SR. (BUSINESS MANAGER)
(951) 246-6152
Entity
Organization
Contact information
Practice address
30290 BUCCANEER BAY UNIT D, MURRIETA, CA 92563-8812
(951) 246-6152
Mailing address
29910 MURRIETA HOT SPRINGS RD STE G304, MURRIETA, CA 92563-3814
(951) 246-6152
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1730625294
NPPES
CA
Enumeration date
02/11/2021
Last updated
02/11/2021
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