ADELL M ELLIS (NPI# 1497837108) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497837108 |
| Entity Type | Individual |
| Full Name | ADELL M ELLIS |
| Practice Address |
3211 Jefferson St San Diego CA 92110-4424 |
| Mailing Address |
9444 Twin Trails Dr San Diego CA 92129-2633 |
| Practice Telephone | 6196833100 |
| Enumeration Date | 2006-10-20 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 373H00000X | Day Training/Habilitation Specialist | Nursing Service Related Providers |
| Street Address |
3211 JEFFERSON ST |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92110-4424 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124100193 | Mary Woods | Marriage & Family Therapist | 3211 Jefferson St, San Diego, CA 92110-4424 | 2006-10-19 |
| 1346563780 | Victoria Campos | Case Manager/Care Coordinator | 3211 Jefferson St, San Diego, CA 92110-4424 | 2010-03-11 |
| 1346563970 | Sarah Rednour | Case Manager/Care Coordinator | 3211 Jefferson St, San Diego, CA 92110-4424 | 2010-03-10 |
| 1336473032 | Brian K Fuller | Case Manager/Care Coordinator | 3211 Jefferson St, San Diego, CA 92110-4424 | 2009-09-28 |
| 1962735050 | Curtis Sutton | Case Manager/Care Coordinator | 3211 Jefferson St, San Diego, CA 92110-4424 | 2009-09-08 |
| 1932333200 | Acacia S O'quinn | Social Worker | 3211 Jefferson St, San Diego, CA 92110-4424 | 2009-05-14 |
| 1417197534 | Courtney Anne Pope | Case Manager/Care Coordinator | 3211 Jefferson St, San Diego, CA 92110-4424 | 2009-03-02 |
| 1578727087 | Antonio J. Pasos | Specialist | 3211 Jefferson St, San Diego, CA 92110-4424 | 2008-07-14 |
| 1982868717 | Dawn Kay Wyatt | Counselor | 3211 Jefferson St, San Diego, CA 92110-4424 | 2008-07-10 |
| 1376715243 | Natalie S. Willard | Specialist | 3211 Jefferson St, San Diego, CA 92110-4424 | 2008-03-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669021713 | Ruben Daniel Gutierrez | Marriage & Family Therapist | 4141 Pacific Coast Hwy, San Diego, CA 92110 | 2019-09-10 |
| 1548724081 | Denise Ellen Thompson | Counselor | 3255 Wings Street, San Diego, CA 92110 | 2019-01-29 |
| 1801378716 | Michelle Lisa Jean Crawford | Student in an Organized Health Care Education/Training Program | 3767 Central Avenue, San Diego, CA 92110 | 2018-09-06 |
| 1427539048 | Allison Turrell | Case Manager/Care Coordinator | 4930 Naples Street, San Diego, CA 92110 | 2018-08-22 |
| 1750872768 | Matthew Langworthy | Physical Therapist | 3405 Kenyon St Ste 212, San Diego, CA 92110 | 2018-05-24 |
| 1245748342 | The One Health Boutique, LLC | Chiropractor | 5350 Riley St, San Diego, CA 92110 | 2018-01-11 |
| 1437670155 | Monique A Fernandez | Counselor | 3132 Jefferson Street, San Diego, CA 92110 | 2017-07-03 |
| 1538510391 | Mayu Winters | Registered Nurse | 853 Rosecrans St, San Diego, CA 92110 | 2016-06-23 |
| 1376998864 | Briniti Ichull | Specialist | 3941 Kurtz St, San Diego, CA 92110 | 2016-05-03 |
| 1912352576 | Healthcare Services, Inc. | Substance Abuse Rehabilitation Facility | 3880 Rosecrans Street, San Diego, CA 92110 | 2016-05-02 |
| Find all providers in zip 92110 | ||||
| Taxonomy Code | 373H00000X |
| Grouping | Nursing Service Related Providers |
| Classification | Day Training/Habilitation Specialist |
| Individuals experienced or trained in working with developmentally disabled individuals who need assistance in acquiring and maintaining life skills that enable them to cope more effectively with the demands of independent living. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184157208 | San Diego Rehab and Fitness | Day Training/Habilitation Specialist | 4184 Madison Ave, San Diego, CA 92116-4709 | 2017-04-05 |
| 1659450443 | Armi Guzman | Day Training/Habilitation Specialist | 446 26th St, San Diego, CA 92102-3026 | 2006-11-03 |
| 1942386636 | Marshall C. Smith | Day Training/Habilitation Specialist | 4660 Viewridge Ave, San Diego, CA 92123-1638 | 2006-10-27 |
| 1245311752 | Timothy Willims | Day Training/Habilitation Specialist | 446 26th St Fl 6, San Diego, CA 92102-3026 | 2006-10-18 |
| 1932321171 | Carmen Maritza Delgaldo | Day Training/Habilitation Specialist | 3853 Rosecrans Street, San Diego, CA 92110 | 2007-05-03 |
| 1275755134 | Keysha Clarke | Day Training/Habilitation Specialist | 3853 Rosecrans Street, San Diego, CA 92110 | 2007-05-02 |
| 1336369917 | Dedra A Hunter | Day Training/Habilitation Specialist | 3853 Rosecrans St, San Diego, CA 92110-3115 | 2007-04-26 |
| 1871712851 | David Wilson | Day Training/Habilitation Specialist | 3853 Rosecrans St, San Diego, CA 92110-3115 | 2007-04-25 |
| 1376762070 | Corazon P Menchaca | Day Training/Habilitation Specialist | 3853 Rosecrans St, San Diego, CA 92110-3115 | 2007-04-24 |
| 1558580001 | Howard S Rubio-fleischer | Day Training/Habilitation Specialist | 3853 Rosecrans St, San Diego, CA 92110-3115 | 2007-04-24 |
| Find all providers in SAN DIEGO | ||||
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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.