Provider Demographics
NPI:1265521439
Name:NEWMAN, ELLEN G (PHD MFT)
Entity type:Individual
Prefix:DR
First Name:ELLEN
Middle Name:G
Last Name:NEWMAN
Suffix:
Gender:F
Credentials:PHD MFT
Other - Prefix:
Other - First Name:ELLEN
Other - Middle Name:
Other - Last Name:GOTTLIEB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:401 GREGORY LANE
Mailing Address - Street 2:SUITE 108
Mailing Address - City:PLEASANT HILL
Mailing Address - State:CA
Mailing Address - Zip Code:94523
Mailing Address - Country:US
Mailing Address - Phone:925-798-3161
Mailing Address - Fax:510-898-3246
Practice Address - Street 1:401 GREGORY LANE
Practice Address - Street 2:SUITE 108
Practice Address - City:PLEASANT HILL
Practice Address - State:CA
Practice Address - Zip Code:94523
Practice Address - Country:US
Practice Address - Phone:925-798-3161
Practice Address - Fax:510-898-3246
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT20264106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
10964919OtherCA0H
150194OtherVO
065690OtherMHN