Individual
ERICKA MARIE ELLISON I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
17075 DEVONSHIRE ST STE 204, NORTHRIDGE, CA 91325-5408
(661) 373-6735
Mailing address
3610 GLENRIDGE DR, SHERMAN OAKS, CA 91423-4639
(818) 631-3547
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
95029523
CA
Other
Enumeration date
07/24/2023
Last updated
12/27/2024
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