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MRS. ELLEN MARIE THEOBALD PHD
NPI 1962576223
Psychologist - Clinical in Riverside, CA

Active since November 20, 2006
5015 CANYON CREST DR, SUITE 203, RIVERSIDE, CA 92507(951) 369-7416(951) 787-9093 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mrs. Ellen Marie Theobald Phd NPPES

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

MRS. ELLEN MARIE THEOBALD PHD (NPI 1962576223) is an individual clinical provider in Riverside, California, licensed in California (PSY9953) and active in the NPI registry since November 2006.

NPPES Registry Identity

NPI1962576223
Entity TypeIndividualFemale
Primary Taxonomy103TC0700X
Provider Legal NameMRS. ELLEN MARIE THEOBALDCredential: PHD
Location Address5015 CANYON CREST DR, SUITE 203Riverside, CA 92507
Mailing Address5307 Stonewood DrRiverside, CA 92506 · (951) 683-2684 · Fax (951) 683-2766
Phone(951) 369-7416
Fax(951) 787-9093
Sole ProprietorNo
Enumeration DateNovember 20, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1962576223 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
License✔ Licensed in CA · PSY9953
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.
5015 CANYON CREST DR, Riverside, CA 92507
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Other Identifiers 2

Medicare ID-Type Unspecified00PL99530
Medicare UPIN00PL99530

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DEREN LELAND MIKELS LCSW
Social Worker (Clinical)
5015 CANYON CREST DR, SUITE 102
RIVERSIDE, CA 92507
Riverside County (951) 529-3692
RHONDA CUFONE MFT
Marriage & Family Therapist
5015 CANYON CREST DR, SUITE 102
RIVERSIDE, CA 92507
Riverside County (951) 333-2359
KEITH TURNER, M.D. A PROFESSIONAL CORPORATION
Psychiatry & Neurology (Psychiatry)
5015 CANYON CREST DR, SUITE 201
RIVERSIDE, CA 92507
Riverside County (951) 320-7090
MR. STEPHEN A GRAY MFT
Marriage & Family Therapist
5015 CANYON CREST DR, SUITE 112
RIVERSIDE, CA 92507
Riverside County (951) 781-0510
EDMUND SHANE KASNER LCSW, MSW, MAM
Social Worker (Clinical)
5015 CANYON CREST DR, SUITE 105
RIVERSIDE, CA 92507
Riverside County (951) 276-0696
THE NELSON WEBLEY CORPORATION
Social Worker (Clinical)
5015 CANYON CREST DR, STE 106
RIVERSIDE, CA 92507
Riverside County (951) 789-2000
MR. PAUL GONSIER M.S.W., L.C.S.W.
Social Worker (Clinical)
5015 CANYON CREST DR, SUITE 110
RIVERSIDE, CA 92507
Riverside County (951) 683-1419
DR. SAMUEL RAMON AGUILERA DC
Chiropractor
5015 CANYON CREST DR, #109
RIVERSIDE, CA 92507
Riverside County (951) 682-2500

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 Ellen Theobald's NPI number?

The NPI number for Ellen Theobald is 1962576223. It was assigned to this individual provider in the NPPES registry on November 20, 2006.

Where is Ellen Theobald located?

Ellen Theobald practices at 5015 Canyon Crest Dr Suite 203, Riverside, CA 92507. The listed phone number is (951) 369-7416.

What is Ellen Theobald'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 Ellen Theobald was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.