Jerry Lee Ellwanger
Jerry Lee Ellwanger is an Addiction (Substance Use Disorder) Counselor in Newark, California. Registered with an NPI since 2009.
- In the registry since
- 2009
Practice location Address checks out
6330 Thornton AveNewark, CA 94560-3734
Phone: (510) 792-4357
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Specialties & licences
| Addiction (Substance Use Disorder) Counselor (primary) | Taxonomy 101YA0400X |
|---|
Record details
| NPI number | 1982845905 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | No |
| NPI enumerated | March 20, 2009 |
| Last updated in NPPES | March 20, 2009 |
| Mailing address | 6330 Thornton Ave, Newark, CA 94560-3734 |
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