Individual
AMANDA ELLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14901 ADELFA DR, LA MIRADA, CA 90638-4749
(909) 536-0110
Mailing address
14901 ADELFA DR, LA MIRADA, CA 90638-4749
(909) 536-0110
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
09/08/2010
Last updated
01/16/2026
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