Shavahna Lanay Ellison
In Home Supportive Care in Martinez, CA. Individual provider (NPI-1).
NPI number1750972790
StatusActive
Last updated in NPPESFeb 2, 2021
Details
- NPI
- 1750972790
- Entity type
- Individual (NPI-1)
- Name
- Shavahna Lanay Ellison
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Feb 2, 2021
- Certification date
- Feb 2, 2021
- Last updated
- Feb 2, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 253Z00000X | In Home Supportive Care | – | – | Yes |
Practice location
758 Shell Ave Apt 1Martinez, CA 94553-3250
Phone 916-410-5664
Mailing address
756 Shell Ave Apt 8Martinez, CA 94553-3249
Phone 209-681-1211
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