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General NPI Number Information
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NPI Number | 1710644828
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Entity Type | Individual
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Provider Name | PATRICK EZELI
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Gender | Male
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Dates
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Enumeration Date | 11/23/2021
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Last Update Date | 10/10/2025
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Provider Practice Location Address
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Address Line | 601 5TH AVE
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City | UPLAND
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State | CA
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Zip | 91786-4839
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Country | US
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Telephone | 909-949-7800
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Fax |
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Provider Business Mailing Address
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Address Line | 7184 CASTLE ROCK WAY
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City | ROSEVILLE
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State | CA
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Zip | 95747-8979
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Country | US
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Telephone | 424-353-1376
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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 | 101YS0200X
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Taxonomy Name | School Counselor
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License Number | 4A1B143F93
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License Number State | CA
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