Kristen Ellis

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

104462 Issued in CA

Practice address

170 Wilkerson Ave Ste a-D
Perris, CA 92570-2200

Phone

(866) 481-5361

NPI assigned

Nov 12, 2015

Sex

Female

Sole proprietor

No

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Recovery Innovations, Inc

  • Adult Mental Health Clinic/Center
  • Perris, CA
  • NPI 1659616266
  NPD (past)

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

{
    "created_epoch": "1447286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559520000000",
    "number": "1174996136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 WILKERSON AVE STE A&B",
            "city": "PERRIS",
            "state": "CA",
            "postal_code": "925702200",
            "telephone_number": "866-481-5361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 WILKERSON AVE STE A-D",
            "city": "PERRIS",
            "state": "CA",
            "postal_code": "925702200",
            "telephone_number": "866-481-5361"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9990 County Farm Rd",
            "address_2": "Suite 6",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "925033542",
            "country_code": "US",
            "telephone_number": "866-481-5361",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "KRISTEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-12",
        "last_updated": "2019-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "104462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Michelle Eckholdt, IMF
• Sara El-Sherbini, DMD
• Eliaa LLC #2
• Eliaa, LLC
• John Elliott
• Ember Care Corporation
• Ember Care HLTH Center of Perris California
• Janeth Itzel Enriquez
• Victor Enriquez
• Erica B Independent Living Facility

• Marriage & Family Therapist in Perris, CA
• Providers in Perris, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2019; 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.