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NPI Code Detail

MEDICARE: STEPHANIE ELLIS

MEDICARE: STEPHANIE ELLIS
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
1235Z00000XSpeech-Language Pathologist31048CA

General Provider Information

NPI Number : 1326982133
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHANIE ELLIS
Provider Business Mailing Address
First Line : 1500 S HAVEN AVE STE 190
Second Line :
City : ONTARIO
State : CA
Zip : 91761-2971
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1500 S HAVEN AVE STE 190
Second Line :
City : ONTARIO
State : CA
Zip : 91761-2971
Country : US
Telephone Number : 909-390-1313
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/14/2026
Last Update Date : 04/14/2026

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Directions to “ STEPHANIE ELLIS ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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