Provider Demographics
NPI:1528413374
Name:ELLU PARTNERS, INC.
Entity Type:Organization
Organization Name:ELLU PARTNERS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:RYAN
Authorized Official - Last Name:GARRELS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:626-796-5481
Mailing Address - Street 1:131 N EL MOLINO AVE
Mailing Address - Street 2:SUITE 220
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-1873
Mailing Address - Country:US
Mailing Address - Phone:626-796-5481
Mailing Address - Fax:626-449-5465
Practice Address - Street 1:131 N EL MOLINO AVE
Practice Address - Street 2:SUITE 220
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-1873
Practice Address - Country:US
Practice Address - Phone:626-796-5481
Practice Address - Fax:626-449-5465
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-29
Last Update Date:2016-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY21050103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty