Lisa Joanne Ellis, is a
Community Health Worker based in Santa Rosa, California. Lisa Joanne Ellis is licensed to practice in * (Not Available) (license number ) and her current practice location is
2245 Challenger Way, Santa Rosa, California. She can be reached at her office (for appointments etc.) via phone at
(707) 565-6338.
NPI number for Lisa Joanne Ellis is 1194960864 and her current mailing address is 1300 Coddingtown Ctr, Santa Rosa, California. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1194960864.
Healthcare Provider's Profile
| Full Name | Lisa Joanne Ellis |
|---|
| Gender | Female |
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| Speciality | Community Health Worker |
|---|
| Location | 2245 Challenger Way, Santa Rosa, California |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1194960864
- Provider Enumeration Date: 12/10/2008
- Last Update Date: 10/31/2024
Medical Identifiers
Medical identifiers for Lisa Joanne Ellis such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1194960864 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
| 172V00000X | Community Health Worker | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Lisa Joanne Ellis is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Lisa Joanne Ellis,
1300 Coddingtown Ctr,
Santa Rosa, CA 95401-3537
Ph: (707) 565-7640 | Lisa Joanne Ellis,
2245 Challenger Way,
Santa Rosa, CA 95407-5418
Ph: (707) 565-6338 |
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