Healthcare Provider Details

I. General information

NPI: 1114854395
Provider Name (Legal Business Name): ELENA KAY MILLNAMOW APCC20549
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 9TH ST
SAN FRANCISCO CA
94103-2603
US

IV. Provider business mailing address

1385 MISSION ST STE 200
SAN FRANCISCO CA
94103-2631
US

V. Phone/Fax

Practice location:
  • Phone: 415-863-4582
  • Fax:
Mailing address:
  • Phone: 415-864-7833
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberAPCC20549
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: