Provider Demographics
NPI:1578501284
Name:TROJNAR, ELLEN T (MS)
Entity Type:Individual
Prefix:MS
First Name:ELLEN
Middle Name:T
Last Name:TROJNAR
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:198 E WHITING AVENUE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92832
Mailing Address - Country:US
Mailing Address - Phone:714-626-0535
Mailing Address - Fax:714-526-5336
Practice Address - Street 1:198 E WHITING AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92832
Practice Address - Country:US
Practice Address - Phone:714-626-0535
Practice Address - Fax:714-526-5336
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-03
Last Update Date:2008-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC25197106H00000X
CA25197106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAMFC251970OtherBLUE SHIELD