Active NPI
Albert Eric Ellsmore, LMFT
- Marriage & Family Therapist
- Turlock, CA
National Provider Identifier
1982732129
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- MFC 29504
- Practice address
- 440 E Canal Dr
Turlock, CA 95380-3936 - Phone
- (209) 668-6121
- Fax
- (209) 656-1487
- NPI assigned
- Mar 1, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | MFC 29504 | CA | Primary |
Addresses
Primary practice location
440 E Canal Dr
Turlock, CA 95380-3936
Mailing address
440 E Canal Dr
Turlock, CA 95380-3936
Phone (209) 668-6121
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq | Health Information Exchange (HIE) | The Permanente Medical Group |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 9, 2025 through Apr 9, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MFC 29504 | CA | MD | Marriage & Family Therapist |
| 29504 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172707200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1640822400000",
"number": "1982732129",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "440 E CANAL DR",
"city": "TURLOCK",
"state": "CA",
"postal_code": "953803936",
"telephone_number": "209-668-6121",
"fax_number": "209-656-1487"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "440 E CANAL DR",
"city": "TURLOCK",
"state": "CA",
"postal_code": "953803936",
"telephone_number": "209-668-6121",
"fax_number": "209-656-1487"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLSMORE",
"first_name": "ALBERT",
"middle_name": "ERIC",
"name_prefix": "Mr.",
"credential": "LMFT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-01",
"last_updated": "2021-12-30",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "MFC 29504",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
"affiliation": "Y",
"endpointDescription": "Carequality",
"affiliationName": "The Permanente Medical Group",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "17000 S Harlan Rd",
"city": "Lathrop",
"state": "CA",
"country_code": "US",
"postal_code": "953308738",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Turlock, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.