Healthcare Provider Details

I. General information

NPI: 1144153255
Provider Name (Legal Business Name): ELLA KATHERINE BELTZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5385 HOLLISTER AVE BLDG 11
GOLETA CA
93111-2389
US

IV. Provider business mailing address

7763 JENNA DR
GOLETA CA
93117-1072
US

V. Phone/Fax

Practice location:
  • Phone: 805-683-8060
  • Fax:
Mailing address:
  • Phone: 805-618-5413
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: