Provider Demographics
NPI:1851775225
Name:SCHARFFENBERG, ELLEN ANN (LCSW)
Entity type:Individual
Prefix:
First Name:ELLEN
Middle Name:ANN
Last Name:SCHARFFENBERG
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6917 LOMA BONITA LN
Mailing Address - Street 2:
Mailing Address - City:EL DORADO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:95762-5116
Mailing Address - Country:US
Mailing Address - Phone:510-685-5697
Mailing Address - Fax:
Practice Address - Street 1:5000 WINDPLAY DR STE 3-209
Practice Address - Street 2:
Practice Address - City:EL DORADO HILLS
Practice Address - State:CA
Practice Address - Zip Code:95762-9357
Practice Address - Country:US
Practice Address - Phone:510-685-5697
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-16
Last Update Date:2025-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW646731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACA185043Medicare PIN