Provider Demographics
NPI:1689759573
Name:MANESS, ELLEN SIDNEY (MSW, LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ELLEN
Middle Name:SIDNEY
Last Name:MANESS
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:MS
Other - First Name:ELLEN
Other - Middle Name:SIDNEY
Other - Last Name:TUROFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, LCSW
Mailing Address - Street 1:1408 CRESTVIEW DR
Mailing Address - Street 2:
Mailing Address - City:SAN CARLOS
Mailing Address - State:CA
Mailing Address - Zip Code:94070-4255
Mailing Address - Country:US
Mailing Address - Phone:650-568-1908
Mailing Address - Fax:
Practice Address - Street 1:200 CHANNING AVE
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94301-2720
Practice Address - Country:US
Practice Address - Phone:650-688-3080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 233641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical