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SELENA ELLIS M.D. NPI 1629443486


NPI Information

NPI: 1629443486
Provider Name: SELENA ELLIS, M.D.
Classification: Psychiatry & Neurology - 2084N0400X
Entity Type: Organization

Specialization: Neurology

Address:
3000 COLBY ST
SUITE 101
BERKELEY, CA
ZIP 94705
Phone: (510) 644-2282
Get Directions

SELENA ELLIS, M.D. is a neurology psychiatry neurology in Berkeley, CA. The provider is a Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. SELENA ELLIS, M.D. NPI is 1629443486. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

3000 COLBY ST
SUITE 101
BERKELEY, CA
ZIP 94705-083
Phone: (510) 644-2282
Fax: (510) 644-1744

The provider's authorized official is Selena W Ellis .
The authorized official title is Doctor and has the following contact phone number (510) 644-2282.

The enumeration date for this NPI number is 12/4/2015 and was last updated on 12/4/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12084N0400XPsychiatry & NeurologyNeurologyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1DO533ZZMEDICARE PINCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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