Kera Marie Ellison, M.ED PPS

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

R1449521121 Issued in CA

Practice address

1124 W Carson St
N-33
Torrance, CA 90502-2006

Phone

(310) 222-5410

Fax

(310) 787-7742

NPI assigned

Nov 12, 2021

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

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

{
    "created_epoch": "1636675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636675200000",
    "number": "1306502463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1124 W CARSON ST",
            "address_2": "N-33",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905022006",
            "telephone_number": "310-222-5410",
            "fax_number": "310-787-7742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1124 W CARSON ST",
            "address_2": "N-33",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905022006",
            "telephone_number": "310-222-5410",
            "fax_number": "310-787-7742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLISON",
        "first_name": "KERA",
        "middle_name": "MARIE",
        "credential": "M.ED PPS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-12",
        "last_updated": "2021-11-12",
        "certification_date": "2021-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "R1449521121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Antesha Shonte Ellis
• Edith Ellis, RN
• Mylah Marie Ellis
• Sharon Ellis, REGISTERED NURSE
• Tierra T. Ellis
• Ellyn R. Ashida, M.D., Inc.
• Maher F Elmasri
• Otilia Elszy, NURSE PRACTITIONER
• Khalid Mohamed Eltawil, MD
• Sandra Lyn Elvik, R.N., C.P.N.P.

• Addiction (Substance Use Disorder) Counselor in Torrance, CA
• Providers in Torrance, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2021; 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.