Individual provider · Type 1 NPI

Ellen Bainer

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

NPI number 1265377204 Active

Practice location

3720 Sunset Ln Ste D
Antioch, CA 94509-6124

Call (415) 456-7724 Map

Mailing address

1480 Lincoln Ave Ste 8
San Rafael, CA 94901-2085

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 1265377204

Ellen Bainer's National Provider Identifier is 1265377204, issued on Apr 23, 2026. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Antioch, CA. The record was last updated on Apr 23, 2026.