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General NPI Number Information
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NPI Number | 1699968024
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Entity Type | Individual
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Provider Name | ELLEN FELTOVICH
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Gender | Female
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Dates
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Enumeration Date | 08/20/2007
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Last Update Date | 07/01/2008
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Provider Practice Location Address
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Address Line | 7901 OAKPORT ST SUITE 3400
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City | OAKLAND
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State | CA
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Zip | 94621-2015
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Country | US
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Telephone | 510-613-0326
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Fax |
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Provider Business Mailing Address
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Address Line | 1001 WARFIELD AVE APT 103
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City | OAKLAND
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State | CA
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Zip | 94610-1602
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Country | US
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Telephone | 510-846-2124
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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