Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Ellen Haddock, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1851823454

Ellen Haddock, MD is a Dermatology in Fremont, California. Graduated from University of California, San Diego School of Medicine in 2017, 9 years ago. Practices with Sutter Bay Medical Foundation, a 3,762-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in California.

Years since qualifying
9
Trained at
University of California, San Diego School of Medicine
Licensed in
CA
In the registry since
2017
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

3200 Kearney St
Fremont, CA 94538-2299
Phone: (510) 498-2374
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 5000 Civic Center Dr, San Rafael, CA 94903-4184 — (415) 499-0100

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X · Licence A157683 (CA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1851823454
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 1, 2017
Last updated in NPPESNovember 18, 2024
Certification dateNovember 18, 2024
Mailing addressPo Box 276950, Sacramento, CA 95827-6950

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyDERMATOLOGY
Medical schoolUNIVERSITY OF CALIFORNIA, SAN DIEGO SCHOOL OF MEDICINE
Graduated 2017 (9 years in practice)
Group practice Sutter Bay Medical Foundation — 3762 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations5 on file with Medicare

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