Individual
MS. DEBORAH R ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN NP
Contact information
Practice address
11201 BENTON ST, LOMA LINDA, CA 92357-1000
(909) 583-6189
Mailing address
PO BOX 609001, SAN DIEGO, CA 92160-9001
(619) 528-4600
(619) 528-4625
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN519425
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
NP13079
CA
Other
Enumeration date
06/07/2006
Last updated
07/13/2010
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