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Ellis Edmunds
Clinical Psychologist in Oakland, California
NPI 1740595768

Ellis Edmunds is a Clinical Psychologist based in Oakland, CA and is specialized in Clinical. Ellis Edmunds practices in Oakland, CA. The NPI Number for Ellis Edmunds is 1740595768 and holds a License No. (California).

The current practice location address for Ellis Edmunds is 4243 Terrace St, Oakland, CA and can be reached out via phone at 510-919-8366.

Location: 4243 Terrace St, Oakland, CA, 94611-5127
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1740595768
Provider Name
Ellis Edmunds
Credential
Provider Entity Type
Individual
Gender
Male
Address
4243 Terrace St, Oakland, CA, 94611-5127
Phone Number
510-919-8366
Fax Number
Provider Enumeration Date
08/13/2010
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
4243 Terrace St
City
Oakland
State
California
Zip
94611-5127
Phone Number
510-919-8366
Fax Number
person
Provider Business Mailing Address Details
Address
4243 Terrace St
City
Oakland
State
California
Zip
94611-5127
Phone Number
510-919-8366
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
-
Taxonomy
101Y00000X
License No.
PSY27058 (California)
Definition
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
person
Provider's Taxonomy Details 2
Type
Behavioral Health & Social Service Providers
Classification
Psychologist
Speciality
Clinical
Taxonomy
103TC0700X
License No.
()
Definition
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
person
Provider's Taxonomy Details 3
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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