Individual
DR. AZELIN ANN ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
3301 E 12TH ST, SUITE 259, OAKLAND, CA 94601-3424
(510) 410-7271
Mailing address
3301 E 12TH ST, SUITE 259, OAKLAND, CA 94601-3424
(510) 410-7271
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
26967
CA
Other
Enumeration date
09/09/2010
Last updated
02/12/2015
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