Healthcare Provider Details

I. General information

NPI: 1457544363
Provider Name (Legal Business Name): ELLA FRANTZ LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/23/2007
Last Update Date: 04/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2225 E BAYSHORE RD # 200
PALO ALTO CA
94303-3220
US

IV. Provider business mailing address

3806 MYKONOS LN # 15
SAN DIEGO CA
92130-5505
US

V. Phone/Fax

Practice location:
  • Phone: 718-375-2647
  • Fax:
Mailing address:
  • Phone: 650-382-4106
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number24714
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: