ELLIS EDMUNDS

OAKLAND, CA
NPI1740595768
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy103TC0700X Psychologist, Clinical
(Licence: CA  PSY27058)
Additional Taxonomies101Y00000X Counselor
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2010-08-13
Last Update Date2020-07-22
Business Address
ELLIS EDMUNDS
4243 TERRACE ST
OAKLAND, CA 94611-5127
Phone number: 510-919-8366
Mailing Address
ELLIS EDMUNDS
4243 TERRACE ST
OAKLAND, CA 94611-5127
Phone number: 510-919-8366