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ELLIS EDMUNDS
NPI 1740595768
Psychologist - Clinical in Oakland, CA

Active since August 13, 2010
4243 TERRACE ST, OAKLAND, CA 94611(510) 919-8366 Get Directions Write a Review

NPPES record last updated: July 22, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Ellis Edmunds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ELLIS EDMUNDS (NPI 1740595768) is an individual clinical provider in Oakland, California, licensed in California (PSY27058) and active in the NPI registry since August 2010. He maintains 2 additional practice locations.

NPPES Registry Identity

NPI1740595768
Entity TypeIndividualMale
Primary Taxonomy103TC0700X
Provider Legal NameELLIS EDMUNDS
Location Address4243 TERRACE STOakland, CA 94611-5127
Mailing Address4243 Terrace StOakland, CA 94611-5127 · (510) 919-8366
Phone(510) 919-8366
Sole ProprietorYes
Enumeration DateAugust 13, 2010
Last NPPES UpdateJuly 22, 2020
NPPES CertifiedJuly 22, 2020
✔ NPI 1740595768 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
License✔ Licensed in CA · PSY27058
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.
Also ListedCounselorTaxonomy 101Y00000X
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
4243 TERRACE ST, Oakland, CA 94611
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Secondary Practice Locations 2

Location 12500 Bissell AveRichmond, CA 94804-1815 · Phone (510) 235-1516
Location 25478A College AveOakland, CA 94618 · Phone (510) 473-5083

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ellis Edmunds's NPI number?

The NPI number for Ellis Edmunds is 1740595768. It was assigned to this individual provider in the NPPES registry on August 13, 2010.

Where is Ellis Edmunds located?

Ellis Edmunds practices at 4243 Terrace St, Oakland, CA 94611. The listed phone number is (510) 919-8366.

What is Ellis Edmunds's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

When was this NPI record last updated?

The NPPES record for Ellis Edmunds was last updated on July 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.