ELLEN MARIE GLAZE (NPI# 1184768103) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184768103 |
| Entity Type | Individual |
| Full Name | ELLEN MARIE GLAZE |
| Other Name | ELLEN MARIE MAYFIELD GLAZE |
| Credential | MS |
| Practice Address |
1515 Market Ave San Pablo CA 94806-4357 |
| Practice Telephone | 5102327571 |
| Practice Fax Number | 5102352545 |
| Mailing Telephone | 5102327571 |
| Mailing Fax Number | 5102352545 |
| Enumeration Date | 2007-02-16 |
| Last Update Date | 2010-11-03 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| Street Address |
1515 MARKET AVE |
| City | SAN PABLO |
| State | CA |
| Zip Code | 94806-4357 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386202166 | Center Point, Inc. | Substance Abuse Rehabilitation Facility | 1515 Market Ave, San Pablo, CA 94806-4357 | 2019-06-05 |
| 1073177069 | Briana Galloway | Counselor | 1515 Market Ave, San Pablo, CA 94806-4357 | 2019-04-25 |
| 1841761699 | Don Lyle Severn | Counselor | 1515 Market Ave, San Pablo, CA 94806-4357 | 2018-12-05 |
| 1225563331 | Kimberly Kim Linh Pham | Counselor | 1515 Market Ave, San Pablo, CA 94806-4357 | 2017-04-26 |
| 1285165167 | Sabrina Ugenti | Counselor | 1515 Market Ave, San Pablo, CA 94806-4357 | 2017-03-23 |
| 1790179760 | Yaqub Hansia | Counselor | 1515 Market Ave, San Pablo, CA 94806-4357 | 2015-03-26 |
| 1154713766 | Leeroy Wainwright | Counselor | 1515 Market Ave, San Pablo, CA 94806-4357 | 2015-02-19 |
| 1861825713 | Brooke C Harrison | Counselor | 1515 Market Ave, San Pablo, CA 94806-4357 | 2013-08-14 |
| 1457600538 | Felix Jackl | Counselor | 1515 Market Ave, San Pablo, CA 94806 | 2012-09-05 |
| 1639427834 | Jeannine Millis | Counselor | 1515 Market Ave, San Pablo, CA 94806-4357 | 2012-08-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013574375 | Alejandra Valle | Behavior Technician | 2970 Hilltop Mall Rd Suite 104, Richmond, CA 94806 | 2019-05-22 |
| 1629535042 | Kaitlin Sue Oshiro | Specialist/Technologist | 16401 San Pablo Ave. Spc 153, San Pablo, CA 94806 | 2019-02-21 |
| 1114400561 | Alan Gonzalez | Pharmacist | 13691 San Pablo Ave., San Pablo, CA 94806 | 2018-09-12 |
| 1265918783 | Laurel Dunn | Student in an Organized Health Care Education/Training Program | 15501 San Pablo Ave # G317, Richmond, CA 94806 | 2018-07-17 |
| 1720503592 | Monika Tippie | Marriage & Family Therapist | West County Adult Mental Health, 13585 San Pablo Ave, 2nd Floor, San Pablo, CA 94806 | 2017-08-14 |
| 1225553902 | Charles Marco Aquilina | Student in an Organized Health Care Education/Training Program | Y Team, 3260 Blume Dr., Suite 450, Richmond, CA 94806 | 2017-08-03 |
| 1922538545 | Hui-teh Hsu | Pharmacist | 2714 Holly St, San Pablo, CA 94806 | 2017-06-15 |
| 1063942878 | Meng-ju Yang | Student in an Organized Health Care Education/Training Program | 3260 Blume Dr., Suite 450, Richmond, CA 94806 | 2017-06-14 |
| 1346780020 | Mae Mayfield | Social Worker | 3600 Sierra Ridge Drive Apt # 7304, Richmond, CA 94806 | 2017-03-01 |
| 1487000790 | Pasha Jackson | Family Medicine | 2970 Hilltop Mall Rd Ste 304, Richmond, CA 94806 | 2016-05-05 |
| Find all providers in zip 94806 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699117861 | Antoine Houff | Counselor | 2575 El Portal Dr, A, San Pablo, CA 94806-0904 | 2013-07-29 |
| 1487886131 | Alonzo Donell Govain Sr. | Counselor | 1330 Contra Costa Avenue., K106, San Pablo, CA 94806-4001 | 2009-08-13 |
| 1205070216 | Marina Lopez | Counselor | 2021 Sutter Ave, San Pablo, CA 94806-4490 | 2009-04-22 |
| 1295942001 | Robert L. Telles | Counselor | 2523 El Portal Dr Ste 102, San Pablo, CA 94806-3305 | 2007-05-17 |
| 1114132982 | Tri-cities | Counselor | 2523 El Portal Dr Ste 206, San Pablo, CA 94806-3305 | 2007-05-14 |
| 1194337576 | Maureen Lucille Brannon | Counselor | 1901 Church Ln, San Pablo, CA 94806-3707 | 2020-08-18 |
| 1982236717 | Rita Schank | Counselor | 1901 Church Ln, San Pablo, CA 94806-3707 | 2020-02-10 |
| 1104457878 | Tamicha Charmaine Bell | Counselor | 1901 Church Ln, San Pablo, CA 94806-3707 | 2020-01-30 |
| 1285280834 | Jamy Renee Kappel | Counselor | 1901 Church Ln, San Pablo, CA 94806-3707 | 2019-08-09 |
| 1073177069 | Briana Galloway | Counselor | 1515 Market Ave, San Pablo, CA 94806-4357 | 2019-04-25 |
| Find all providers in SAN PABLO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.