Ericka Marie Ellison I
Individual provider Active NPI Psychiatry Physician · Northridge, CA
NPI 1316627326 · NPPES record last updated Dec 27, 2024
Key facts
- NPI
- 1316627326
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatry Physician 2084P0800X
- License
- 95029523 (CA)
- Practice address
- 17075 Devonshire St Ste 204
Northridge, CA 91325-5408 - Phone
- (661) 373-6735
- NPI assigned
- Jul 24, 2023
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 19
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Unicare Community Health Center, Inc.
Practice addresses (Care Compare)
741 S Alvarado St
Los Angeles, CA 90057-4021
Phone (213) 413-6666
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250508000209 | CA | Practitioner - Nurse Practitioner | 0446777916 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95029523 | CA | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Unicare Community Health Center, Inc. | Current |
Accepting new patients | |
| Unicare Community Health Center Inc | Current | Accepting new patients | |
| Unicare Community Health Center, Inc. | Current |
Accepting new patients |
Locations
107 N McKinley St
Corona, CA 92879
Phone (951) 358-0141
741 S Alvarado St
Los Angeles, CA 90057
Phone (213) 413-6666
1151 E Walnut St
Ontario, CA 91761
Phone (909) 467-0797
437 N Euclid Ave
Ontario, CA 91762
Phone (909) 749-1835
1501 E Holt Ave
Ste A
Pomona, CA 91767
Phone (909) 623-3600
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 95029523 | CA | Yes |
Addresses
Primary practice location
17075 Devonshire St Ste 204
Northridge, CA 91325-5408
Mailing address
3610 Glenridge Dr
Sherman Oaks, CA 91423-4639
Phone (818) 631-3547
Other providers in Northridge, CA
- Elite Caregivers Hospice Care Inc
- Isak Elkayam
- Ellen Shuham OD Inc
- Russell Lance Ellis
- Alisha Ellison
- Emericare Inc
- Emet Nursing and Wound Care, a Professional Corporation
- Emw Pharmacy Inc
- Encino Home Health Services, Inc.
- Endeavor Recovery LLC
All providers in Northridge, CA · Psychiatry Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 27, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.