MR. LARRY EDWARD ELLIS (NPI# 1205311339) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205311339 |
| Entity Type | Individual |
| Full Name | MR. LARRY EDWARD ELLIS |
| Credential | RADT |
| Practice Address |
800 S Victoria Ave Ventura CA 93009-0001 |
| Practice Telephone | 8057665620 |
| Mailing Telephone | 8057665620 |
| Enumeration Date | 2018-09-25 |
| Last Update Date | 2018-09-25 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
R1290810218 | CA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376934778 | Larry D Ellis Sr. | Contractor | 2215 Steep Pine Trl, Fresno, TX 77545-8831 | 2015-02-07 |
| 1437578366 | Larry Ellis | Counselor | 11104 W Meadow Creek Dr, Milwaukee, WI 53224-5053 | 2014-04-08 |
| 1124499405 | Larry D. Ellis | Counselor | 2664 S Harper Rd, Corinth, MS 38834-6723 | 2015-10-13 |
| 1710138771 | Larry Lamar Ellis | Pharmacist | 10 S Main St, Driggs, ID 83422-9700 | 2008-10-08 |
| 1972572576 | Larry L Ellis | Family Medicine | 2345 Southwest Blvd, Tulsa, OK 74107-2705 | 2006-03-16 |
| Street Address |
800 S VICTORIA AVE |
| City | VENTURA |
| State | CA |
| Zip Code | 93009-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700082302 | Lorita Faye Meeks | Counselor | 800 S Victoria Ave, Room 301, Ventura, CA 93009-0001 | 2007-06-21 |
| 1902422439 | Crista Marie Arnold | Nurse Practitioner | 800 S Victoria Ave, Ventura, CA 93009-0001 | 2020-06-20 |
| 1891341517 | Ktlenne Lehi Lazo | Nurse Practitioner | 800 S Victoria Ave, Ventura, CA 93009-0001 | 2019-08-18 |
| 1992194096 | Kelly Muklevicz | Counselor | 800 S Victoria Ave, Ventura, CA 93009-8520 | 2015-01-13 |
| 1740578327 | Andrea L Anderson | Counselor | 800 S Victoria Ave, Ventura, CA 93009-1651 | 2011-07-15 |
| 1306039292 | Heather Te | Marriage & Family Therapist | 800 S Victoria Ave, Ventura, CA 93009 | 2007-08-23 |
| 1811193741 | Sara Estrada | Counselor | 800 S Victoria Ave, Ventura, CA 93009-0001 | 2007-06-26 |
| 1295931756 | Rachel P Calof | Counselor | 800 S Victoria Ave, Ventura, CA 93009-0001 | 2007-06-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730340977 | Michele Ayans | Physician Assistant | 1190 S Victoria Ave, Suite 300, Ventura, CA 93009 | 2008-06-20 |
| 1316371677 | Erin Michelle Opdahl | Marriage & Family Therapist | 800 S Victoria Ave # 4615, Ventura, CA 93009-0001 | 2013-08-22 |
| 1427523885 | Valerie Supan | Social Worker | 800 S Victoria Ave # 4615, Ventura, CA 93009-0001 | 2018-10-11 |
| 1902843410 | Sandra K Ybarra | Physician Assistant | Ehs 800 S Victoria, Sbch-ed Puebo @bath, Santa Barbara, Ca Ed, Ventura, CA 93009-1150 | 2006-06-01 |
| 1265552236 | Pamela Judy Bogen | Social Worker | 800 S Victoria Ave # L4615, Ventura, CA 93009-2103 | 2007-03-31 |
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952929739 | Christine Yana Barna | Counselor | 641 E Thompson Blvd, Ventura, CA 93001 | 2020-07-08 |
| 1326688979 | Ruby Johnstone | Counselor | 334 W Harrison Ave, Ventura, CA 93001-1826 | 2020-01-12 |
| 1700379096 | Terrence Swanson | Counselor | 125 W Harrison Ave Apt A, Ventura, CA 93001 | 2018-06-11 |
| 1649793308 | Melissa Gerwe | Counselor | 5495 Hollings St, Ventura, CA 93003-2227 | 2017-07-24 |
| 1083074116 | Robert Lightcap | Counselor | 1175 Chalmette Ave, Ventura, CA 93003-5856 | 2016-03-02 |
| 1699165589 | Carlos Antonio Menendez I | Counselor | 536 E Thompson Blvd, Ventura, CA 93001-2841 | 2015-01-29 |
| 1184048860 | Kimberly Andre Fouche | Counselor | 260 Maple Ct Ste 250, Ventura, CA 93003-3571 | 2014-02-14 |
| 1982034096 | Flora Estelle Prouse | Counselor | 5225 Telegraph Rd Fl 2, Ventura, CA 93003-4113 | 2013-11-26 |
| 1619255296 | Julie L. Howard-balmer | Counselor | 3160 Telegraph Rd Ste 103, Ventura, CA 93003-3246 | 2011-07-29 |
| 1669761532 | Ted Wrablik | Counselor | 9050 Feather Street, Ventura, CA 93004 | 2011-03-31 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.