Individual
ANDREW JORDAN ELLEDGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
11041 VALLEY BLVD, EL MONTE, CA 91731-2516
(626) 442-4177
Mailing address
484 E HOWARD ST, PASADENA, CA 91104-2241
(810) 931-1966
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
12/22/2011
Last updated
12/22/2011
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