NPI Lookup
NPI Lookup from the NPI Registry — National Provider Identifier Database

Contact Information

ROBERTA M ELLEDGE, LMFT
819 15TH ST
MODESTO, CA95354-1113
 Phone: 209-549-9608
 Fax: 209-522-5700
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Marriage & Family Therapist

106H00000X
Indicates primary specialty

NPI Profile & details for ROBERTA M ELLEDGE · (Female)

NPI Number 1003028473
Status Active
Credentials LMFT (Licensed Marriage and Family Therapist)
Entity Individual
Enumeration date 05/05/2007
Last updated 07/08/2007 - About 12 years ago
Sole proprietor 1 Yes
Identifiers
  • CA License # MFC31467
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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