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General NPI Number Information
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NPI Number | 1083818132
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Entity Type | Individual
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Provider Name | NANCY ELLIS-CAWLEY L.C.S.W.
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Gender | Female
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Dates
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Enumeration Date | 06/13/2007
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Last Update Date | 03/25/2010
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Provider Practice Location Address
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Address Line | 8080 MADISON AVE 200A
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City | FAIR OAKS
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State | CA
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Zip | 95628-3759
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Country | US
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Telephone | 916-361-2928
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Fax | 916-962-0956
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Provider Business Mailing Address
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Address Line | 8080 MADISON AVE 200A
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City | FAIR OAKS
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State | CA
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Zip | 95628-3799
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Country | US
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Telephone | 916-361-2928
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 12195
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License Number State | CA
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