Mary Ann Ellis-Jammal, M.D.
Pediatrics in Roseville, CA. Individual provider (NPI-1).
NPI number1245341817
StatusActive
Last updated in NPPESSep 22, 2022
Details
- NPI
- 1245341817
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Mary Ann Ellis-Jammal
- Credential
- M.D.
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Aug 31, 2006
- Certification date
- Sep 22, 2022
- Last updated
- Sep 22, 2022
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208000000X | Pediatrics | A37659 | CA | Yes |
Practice location
151 N. Sunrise Ave Suite 1403Roseville, CA 95661
Phone 916-771-4414 · Fax 916-771-4411
Mailing address
151 N. Sunrise Ave Suite 1403Roseville, CA 95661
Phone 916-771-4414 · Fax 916-771-4411
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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