Ellis, Jason
Ellis, Jason is an sole proprietor health care provider with primary practice located at 31764 Casino Dr Ste 300 , Lake Elsinore CA 92530-2312. He recently has 3 registered licenses in different health care specialties including Other Service Providers / Peer Specialist, Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Ellis, Jason can be contacted via phone (951) 471-4645.Contact Information
Primary practice address
31764 Casino Dr Ste 300
Lake Elsinore CA 92530-2312
Phone: (951) 471-4645
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Peer Specialist | 175T00000X | ||
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | ||
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X |
Profile Details
| NPI number | 1578924858 |
|---|---|
| LBN Legal business name | Ellis, Jason |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 14th, 2016 |
| Last updated | Apr 16th, 2024 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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