Individual
KRISTEN ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDN
Contact information
Practice address
2121 BAYPOINTE DR, NEWPORT BEACH, CA 92660-8518
(585) 313-2952
Mailing address
2121 BAYPOINTE DR, NEWPORT BEACH, CA 92660-8518
(585) 313-2952
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
135522
CA
106H00000X
Marriage & Family Therapist
AMFT135522
CA
133V00000X
Registered Dietitian
Primary
—
CA
Other
Enumeration date
06/14/2018
Last updated
10/27/2022
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