MEDICARE: TAMARA ELLING

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041S0200X	School Social Worker

General Provider Information

NPI Number	:	1083592091
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAMARA ELLING

Provider Business Mailing Address
First Line	:	1835 GUM TREE LN
Second Line	:
City	:	FALLBROOK
State	:	CA
Zip	:	92028-5507
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1835 GUM TREE LN
Second Line	:
City	:	FALLBROOK
State	:	CA
Zip	:	92028-5507
Country	:	US
Telephone Number	:	760-695-9947
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/26/2025
Last Update Date	:	08/26/2025

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Directions to “ TAMARA ELLING ” Practice Location

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