Sandi Rose Ellerbe, SUDCC 8646

Primary specialty

Rehabilitation PractitionerTaxonomy code 225400000X

Practice address

2101 Courage Dr
Fairfield, CA 94533-6717

Phone

(707) 639-4675

Fax

(707) 639-4700

NPI assigned

Mar 31, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 5

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.

• House of Acts

  • Substance Abuse Rehabilitation Facility
  • Vallejo, CA
  • NPI 1326352188
  NPD (past)

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

{
    "created_epoch": "1490918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693353600000",
    "number": "1528590262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 COURAGE DR",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945336717",
            "telephone_number": "707-639-4675",
            "fax_number": "707-639-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 COURAGE DR",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945336717",
            "telephone_number": "707-639-4675",
            "fax_number": "707-639-4700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1310 Club Dr",
            "address_purpose": "LOCATION",
            "city": "Vallejo",
            "state": "CA",
            "postal_code": "945921187",
            "country_code": "US",
            "telephone_number": "707-333-0601",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "220 Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Vallejo",
            "state": "CA",
            "postal_code": "945892517",
            "country_code": "US",
            "telephone_number": "707-333-0601",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "627 Grant St",
            "address_purpose": "LOCATION",
            "city": "Vallejo",
            "state": "CA",
            "postal_code": "945907228",
            "country_code": "US",
            "telephone_number": "707-553-1042",
            "fax_number": "707-553-8146",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLERBE",
        "first_name": "SANDI",
        "middle_name": "ROSE",
        "name_prefix": "Mrs.",
        "credential": "SUDCC 8646",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-31",
        "last_updated": "2023-08-30",
        "certification_date": "2023-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "8646",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandra Ruth Elder, DMD
• Alonya Elgrably, NP
• Avery Eric Elias, MHSII
• Paul Peter Eliopoulos
• Salem I Elkhayat, M.D
• Darrell Lamont Ellingberg Jr.
• Joshua Thomas Ellington
• Leland Dean Elliott, RBT
• Billy Frank Ellis Jr.
• Mark H Ellis, MD

• Rehabilitation Practitioner in Fairfield, CA
• Providers in Fairfield, CA by specialty
• Rehabilitation Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2023; 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.