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Individual

ERICA ELLIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
9606 TIERRA GRANDE ST STE 107, SAN DIEGO, CA 92126-6501
(858) 695-9415
Mailing address
9606 TIERRA GRANDE ST STE 107, SAN DIEGO, CA 92126-6501
(858) 695-9415

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
RPE8871
CA

Other

Enumeration date
05/02/2014
Last updated
05/02/2014
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