Provider Demographics
NPI:1821451964
Name:LIGUORI, ELLEN FRANCES (NP-C)
Entity Type:Individual
Prefix:MS
First Name:ELLEN
Middle Name:FRANCES
Last Name:LIGUORI
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58471 29 PALMS HWY
Mailing Address - Street 2:SUITE 201
Mailing Address - City:YUCCA VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92284
Mailing Address - Country:US
Mailing Address - Phone:760-228-1114
Mailing Address - Fax:760-228-2066
Practice Address - Street 1:58471 29 PALMS HWY
Practice Address - Street 2:SUITE 201
Practice Address - City:YUCCA VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92284
Practice Address - Country:US
Practice Address - Phone:760-228-1114
Practice Address - Fax:760-228-2066
Is Sole Proprietor?:No
Enumeration Date:2016-04-04
Last Update Date:2017-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95003945363LA2200X, 363LG0600X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology