Individual
ELLIEANNA MAE FORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4411 E CESAR CHAVEZ BLVD # 319, FRESNO, CA 93702-3604
(559) 600-2382
Mailing address
3433 W SHAW AVE STE 103, FRESNO, CA 93711-3229
(559) 558-4051
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
171M00000X
Case Manager/Care Coordinator
—
—
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
10/02/2020
Last updated
09/27/2024
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