CHARLES ELLIS

RIVERSIDE, CA
NPI1215017009
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: CA  LCS 19143)
Additional Taxonomies1041C0700X Social Worker, Clinical
(Licence: NV  5980-C)
1041C0700X Social Worker, Clinical
(Licence: MD  26960)
Enumeration Date2006-10-16
Last Update Date2024-10-09
Business Address
Mr. CHARLES ELLIS LCSW-C
4164 BROCKTON AVE
RIVERSIDE, CA 92501-3400
Phone number: 951-683-5193
Mailing Address
Mr. CHARLES ELLIS LCSW-C
4164 BROCKTON AVE
RIVERSIDE, CA 92501-3400
Phone number: 951-683-5193