Individual provider Active NPI

Ariel Madison Ellis, LEP, MA, PPS, NCSP

  • School Psychologist
  • Chico, CA
National Provider Identifier
1003644253
Registry record updated Jul 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
School PsychologistTaxonomy code 103TS0200X
License
LEP4456 Issued in CA
Practice address
3 El Cortez Cir
Chico, CA 95926-1210
Phone
(530) 332-8249
NPI assigned
Jul 22, 2024
Last updated
Jul 22, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 22, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Psychologist 103TS0200X LEP4456 CA Primary

Addresses

Primary practice location

3 El Cortez Cir
Chico, CA 95926-1210

Mailing address

550 Vallombrosa Avenue PO Box #201
Chico, CA 95926

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
LEP4456CAMDSchool Psychologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1721606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721606400000",
    "number": "1003644253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 VALLOMBROSA AVENUE PO BOX #201",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "95926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 EL CORTEZ CIR",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959261210",
            "telephone_number": "530-332-8249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "ARIEL",
        "middle_name": "MADISON",
        "credential": "LEP, MA, PPS, NCSP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-22",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "CA",
            "license": "LEP4456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chico, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.