Provider Demographics
NPI:1457544363
Name:FRANTZ, ELLA (LCSW)
Entity Type:Individual
Prefix:
First Name:ELLA
Middle Name:
Last Name:FRANTZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3806 MYKONOS LN
Mailing Address - Street 2:# 15
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92130-5505
Mailing Address - Country:US
Mailing Address - Phone:650-382-4106
Mailing Address - Fax:
Practice Address - Street 1:2225 E BAYSHORE RD
Practice Address - Street 2:# 200
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94303-3220
Practice Address - Country:US
Practice Address - Phone:718-375-2647
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-23
Last Update Date:2017-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA247141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYNB9351Medicare PIN