Individual provider · Type 1 NPI

Nicole Ellis

Student in an Organized Health Care Education/Training Program · Los Angeles, CA

NPI number 1053555995 Active

Practice location

1200 N State St, Ct, 7th Floor, Room A7E
Los Angeles, CA 90033-1029

Call (310) 920-5057 Map

Mailing address

620 The Vlg, 109
Redondo Beach, CA 90277-2747

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1053555995

Nicole Ellis's National Provider Identifier is 1053555995, issued on Apr 22, 2009. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Los Angeles, CA. The record was last updated on Apr 22, 2009.