Search › California › 163W00000X
Tia Ellis
NPI 1811652498 · on the registry since 2021
Practice
- Address
- 15850 42nd Ave
Clearlake, CA 95422 - Phone
- (707) 349-8126
Registry record
- Primary taxonomy
- 163W00000X
163W00000X
- Licence states on file
- CA
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2021-11-08
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California