Individual
TIERRA T. ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1819 SAN ARDO ST, TORRANCE, CA 90501
(323) 432-0389
Mailing address
3705 W PICO BLVD # 835, LOS ANGELES, CA 90019-3451
(323) 432-0389
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
225C00000X
Rehabilitation Counselor
—
—
Other
Enumeration date
10/02/2012
Last updated
05/24/2021
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