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Search › California › 172V00000X

Lincoln Ellis

NPI 1962081539 · on the registry since 2021

Practice

Address
1212 N California St
Stockton, CA 95202
Phone
(209) 922-3254
Organisation at this address
Sasha Jackson, Llc
County Of San Joaquin
Larisa Kouperschmidt Md Llc
Bhs Children And Youth Serv
San Joaquin County Mental Health
Inferred from a shared address, not stated in the registry.
Clinicians at this address
844

Registry record

Primary taxonomy
172V00000X
172V00000X
Also registered as
174400000X
373H00000X
Licence states on file
CA
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2025-03-21

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