MS. ELLEN ANN BOURNE (NPI# 1669619714) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669619714 |
| Entity Type | Individual |
| Full Name | MS. ELLEN ANN BOURNE |
| Credential | MSW |
| Practice Address |
7000 S Center Dr B Clearlake CA 95422-8131 |
| Practice Telephone | 7079947090 |
| Practice Fax Number | 7079947092 |
| Mailing Telephone | 7079947090 |
| Mailing Fax Number | 7079947092 |
| Enumeration Date | 2009-01-12 |
| Last Update Date | 2011-05-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316588536 | Ellen Rose Bourne | Nurse's Aide | 7710 W Interstate 10, San Antonio, TX 78230-4711 | 2019-09-30 |
| Street Address |
7000 S CENTER DR B |
| City | CLEARLAKE |
| State | CA |
| Zip Code | 95422-8131 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851457022 | Raul Wybo-gilbert | Counselor | 7000 S Center Dr, Clearlake, CA 95422-8131 | 2006-12-29 |
| 1518498658 | Janet Wolfley | Registered Nurse | 7000 S Center Dr, Clearlake, CA 95422-8131 | 2017-03-21 |
| 1770023764 | Rebecca Ann Marengo | Case Manager/Care Coordinator | 7000 S Center Dr, Clearlake, CA 95422-8131 | 2017-02-24 |
| 1053547034 | Elise Patricia Anne Jones | Counselor | 7000 S Center Dr, Clearlake, CA 95422 | 2009-06-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831729201 | Richard Charles Hammond | Counselor | 7000 B South Center Drive, Clearlake, CA 95422 | 2020-01-24 |
| 1609416437 | Junirose Thom | Behavioral Analyst | 4456 Manzanita Avenue Suite 2, Clearlake, CA 95422 | 2020-01-09 |
| 1649781360 | Lake County Office of Education | Local Education Agency (LEA) | 3350 Acacia St, Clearlake, CA 95422 | 2017-10-20 |
| 1083091326 | Noelle Menesini | Physician Assistant | 15230 Lake Shore Drive, Clearlake, CA 95422 | 2015-05-06 |
| 1861820979 | Lake County Office of Education | Local Education Agency (LEA) | 6945 Old Highway 53, Clearlake, CA 95422 | 2013-10-29 |
| 1124469838 | Hassan Sheikh Moghaddas | Surgery | 15332 Lakeshore Dr Ste 101, Clearlake, CA 95422 | 2013-07-10 |
| 1366710279 | Nancy Bylund | Licensed Psychiatric Technician | 7000b South Center Drive, Clearlake, CA 95422 | 2011-12-06 |
| 1699060830 | Planned Parenthood Shasta Pacific | Clinic/Center | 1437 Olympic Drive, Cleaklake, CA 95422 | 2011-06-16 |
| 1164655247 | Hector Lara | Counselor | 14130 Lakeshore Dr., Clearlake, CA 95422 | 2009-08-24 |
| 1518197607 | Vishal V Desai | Pharmacist | 15025, Olympic Drive, Clearlake, CA 95422 | 2009-07-23 |
| Find all providers in zip 95422 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114240033 | Gerald Douglas Rine | Counselor | 2971 Garner Ln, Clearlake, CA 95422-9556 | 2010-03-05 |
| 1639301534 | Dow Edwin Walton | Counselor | 7000#b South Center Drive, Clearlake, CA 95422-8106 | 2009-08-11 |
| 1760539407 | Shirin Roberts | Counselor | 15145a Lakeshore Dr., Clearlake, CA 95422 | 2007-01-04 |
| 1235299843 | Judy Wilhite | Counselor | 15145 Lakeshore Dr., Clearlake, CA 95422 | 2006-12-12 |
| 1952460735 | Scott Harvey Robbins | Counselor | 15145a Lakeshore Dr, Clearlake, CA 95422-8106 | 2006-12-07 |
| 1548328073 | Margaret Mary Cerbasi | Counselor | 15145 Lakeshore Drive, Clearlake, CA 95422 | 2006-12-05 |
| 1356994925 | Yesica Meza | Counselor | 7000b S Center Dr, Clearlake, CA 95422-8131 | 2019-07-22 |
| 1053884395 | Richard Allan Cohn Jr. | Counselor | 7000b S Center Dr, Clearlake, CA 95422-8131 | 2019-01-09 |
| 1033699129 | Sherry Bauman | Counselor | 6945 Old Highway 53, Clearlake, CA 95422-9381 | 2018-08-17 |
| 1063998292 | Elizabeth Salcedo Abrica | Counselor | 7000b S Center Dr, Clearlake, CA 95422-8131 | 2018-07-11 |
| Find all providers in CLEARLAKE | ||||
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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.