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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 8 months 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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