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NPI Code Detail

MEDICARE: MS. SUE ELLEN ANNIS

MEDICARE: MS. SUE ELLEN ANNIS
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
11041C0700XClinical Social WorkerLCSW116388CA
2104100000XSocial Worker
3171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1710005558
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SUE ELLEN ANNIS
Provider Business Mailing Address
First Line : 10330 PIONEER BLVD STE 215
Second Line :
City : SANTA FE SPRINGS
State : CA
Zip : 90670-8277
Country : US
Telephone Number : 562-402-0677
Fax Number :
Provider Business Practice Location Address
First Line : 10330 PIONEER BLVD STE 215
Second Line :
City : SANTA FE SPRINGS
State : CA
Zip : 90670-8277
Country : US
Telephone Number : 562-402-0677
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/27/2007
Last Update Date : 03/23/2026

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Directions to “ MS. SUE ELLEN ANNIS ” Practice Location

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