Provider Demographics
NPI:1467588715
Name:MECHLING, ELLEN M (MFT)
Entity Type:Individual
Prefix:
First Name:ELLEN
Middle Name:M
Last Name:MECHLING
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3400 DATA DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670-7956
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1730 PRAIRIE CITY RD STE 120
Practice Address - Street 2:
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-9594
Practice Address - Country:US
Practice Address - Phone:916-924-6400
Practice Address - Fax:916-648-0196
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC38296106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000810786096OtherPHCS
CA451454OtherINTERPLAN
CAMFT382960OtherBLUE SHIELD
CA2044726OtherGREAT WEST
CA5694182OtherFIRST HEALTH
CA7978340OtherAETNA
CA90203902OtherPACIFICARE
CAMFC38296OtherBLUE CROSS
CAMCMG464500OtherWESTERN HEALTH ADVANTAGE