Individual provider · Type 1 NPI

Kim Ellis

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

NPI number 1780176008 Active

Practice location

629 Oakland Ave
Oakland, CA 94611-4567

Call (415) 340-2504 Map

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 1780176008

Kim Ellis's National Provider Identifier is 1780176008, issued on Jun 1, 2018. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Oakland, CA. The record was last updated on Mar 30, 2026.