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General NPI Number Information
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NPI Number | 1215311949
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Entity Type | Individual
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Provider Name | CORINN ELMORE
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Gender | Female
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Dates
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Enumeration Date | 07/13/2015
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Last Update Date | 04/14/2025
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Provider Practice Location Address
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Address Line | 2150 CAPITOL AVE
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City | SACRAMENTO
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State | CA
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Zip | 95816-5748
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Country | US
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Telephone | 415-649-0782
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Fax |
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Provider Business Mailing Address
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Address Line | 48 SUN REIGN PL
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City | SACRAMENTO
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State | CA
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Zip | 95823-6738
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Country | US
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Telephone | 916-396-5945
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 06045
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY35187
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License Number State | CA
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