Individual
ASHANTAI ELLINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2045 FAIRMONT DR, SAN LEANDRO, CA 94578-1088
(510) 667-7500
(510) 667-7522
Mailing address
2045 FAIRMONT DR, SAN LEANDRO, CA 94578-1088
(510) 667-7500
(510) 667-7522
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
06/16/2016
Last updated
06/16/2016
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