Individual
SYDNEY ELLESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
58945 BUSINESS CENTER DR STE D, YUCCA VALLEY, CA 92284-7310
(760) 228-9657
Mailing address
58945 BUSINESS CENTER DR STE D, YUCCA VALLEY, CA 92284-7310
(760) 228-9657
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
175T00000X
PEER SPECIALIST
CA
Enumeration date
03/06/2023
Last updated
03/06/2023
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