Provider Demographics
NPI:1356369698
Name:BIER, ELLEN SHIRLEY (PT)
Entity type:Individual
Prefix:MS
First Name:ELLEN
Middle Name:SHIRLEY
Last Name:BIER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3031 TELEGRAPH AVE
Mailing Address - Street 2:STE 131
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94705-2051
Mailing Address - Country:US
Mailing Address - Phone:510-843-9110
Mailing Address - Fax:510-843-9110
Practice Address - Street 1:3031 TELEGRAPH AVE
Practice Address - Street 2:STE 131
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94705-2051
Practice Address - Country:US
Practice Address - Phone:510-843-9110
Practice Address - Fax:510-843-9110
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2008-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA118062251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ09236ZOtherBLUE SHIELD PROVIDER #
CAZZZ30105ZMedicare ID - Type UnspecifiedPROVIDER NUMBER