MEDICARE: CYPRESS HEALTH LICENSED CLINICAL SOCIAL WORKER INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1972386779
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CYPRESS HEALTH LICENSED CLINICAL SOCIAL WORKER INC.

Provider Business Mailing Address
First Line	:	1775 WOODSIDE RD STE 301
Second Line	:
City	:	REDWOOD CITY
State	:	CA
Zip	:	94061-3458
Country	:	US
Telephone Number	:	650-564-4878
Fax Number	:	651-260-5004

Provider Business Practice Location Address
First Line	:	1775 WOODSIDE RD STE 301
Second Line	:
City	:	REDWOOD CITY
State	:	CA
Zip	:	94061-3458
Country	:	US
Telephone Number	:	650-564-4878
Fax Number	:	651-260-5004

Authorized Official
Title or Position	:	PRESIDENT
Name	:	APRIL ELLIS
Credential	:	LCSW
Telephone Number	:	415-867-1419

Provider Enumeration Date	:	08/15/2023
Last Update Date	:	12/05/2025

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