Provider Demographics
NPI:1740388305
Name:TRUSCHEL, ELLEN J (MA)
Entity Type:Individual
Prefix:MRS
First Name:ELLEN
Middle Name:J
Last Name:TRUSCHEL
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 3626
Mailing Address - Street 2:
Mailing Address - City:PINEDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93650
Mailing Address - Country:US
Mailing Address - Phone:559-908-2991
Mailing Address - Fax:559-272-0377
Practice Address - Street 1:215 W. FALLBOOK AVE.
Practice Address - Street 2:SUITE 124
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93711
Practice Address - Country:US
Practice Address - Phone:559-908-2991
Practice Address - Fax:559-272-0377
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2013-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC43361106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist