Organization
ELLIS PSYCHOLOGICAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIERRA T. ELLIS PH.D. (PSYCHOLOGIST)
(323) 432-0389
Entity
Organization
Contact information
Practice address
1819 SAN ANDRO 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
103TC0700X
Clinical Psychologist
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
05/20/2021
Last updated
05/20/2021
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