Individual
ANNIE CARRICO ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3908 ALAMEDA AVE APT A, CAPITOLA, CA 95010-2945
(408) 239-7224
Mailing address
3908 ALAMEDA AVE APT A, CAPITOLA, CA 95010-2945
(408) 239-7224
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
—
—
Other
Enumeration date
09/06/2022
Last updated
09/06/2022
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