Ellyn Ann Hazelton, L.C.S.W.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCS15525 Issued in CA

Practice address

10992 San Diego Mission Rd
San Diego, CA 92108-2444

Phone

(619) 641-4100

Fax

(619) 641-4111

NPI assigned

Mar 27, 2007

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": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1831217876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10280 GAUL WAY",
            "city": "SPRING VALLEY",
            "state": "CA",
            "postal_code": "919771717",
            "telephone_number": "619-660-7387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10992 SAN DIEGO MISSION RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921082444",
            "telephone_number": "619-641-4100",
            "fax_number": "619-641-4111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAZELTON",
        "first_name": "ELLYN",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS15525",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tiffany Nicole Hazel
• Paul Nolan Hazelbaker, DO
• Hazelden Betty Ford Foundation
• Crystal Hazelton, MPT
• Elizabeth Lynne Hazelton, RCP, RRT
• Michele Hazelwood
• Andrea Lynn Hazen, PHD
• Erica Lynn Hazen
• Dana Alexander Hazlett
• John Hunter Hazlett, OTR

• Clinical Social Worker in San Diego, CA
• Providers in San Diego, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.