Provider Demographics
NPI:1003596834
Name:PELLITTERI, ELENA
Entity Type:Individual
Prefix:
First Name:ELENA
Middle Name:
Last Name:PELLITTERI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ELENA
Other - Middle Name:
Other - Last Name:CRAMMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1880 SHASTA ST
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96001-0417
Mailing Address - Country:US
Mailing Address - Phone:530-225-5185
Mailing Address - Fax:
Practice Address - Street 1:1880 SHASTA ST
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-0417
Practice Address - Country:US
Practice Address - Phone:530-225-5185
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-18
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95271176163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse