Ellin Sadur

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY10019 Issued in CA

Practice address

2817 Crow Canyon Rd. #204B
San Ramon, CA 94583

Phone

(925) 831-0341

Fax

(925) 855-9075

NPI assigned

Dec 13, 2013

Last updated

Dec 13, 2013By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1386892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386892800000",
    "number": "1114358330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2817 CROW CANYON RD STE 204B",
            "city": "SAN RAMON",
            "state": "CA",
            "postal_code": "945831639",
            "telephone_number": "925-831-0341",
            "fax_number": "925-855-9075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2817 CROW CANYON RD. #204B",
            "city": "SAN RAMON",
            "state": "CA",
            "postal_code": "94583",
            "telephone_number": "925-831-0341",
            "fax_number": "925-855-9075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SADUR",
        "first_name": "ELLIN",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-12-13",
        "last_updated": "2013-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY10019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in San Ramon, CA
• Providers in San Ramon, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2013; 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.