Provider Demographics
NPI:1992740112
Name:ODZA, ELLEN CURTIS (MA, LMFT)
Entity type:Individual
Prefix:MS
First Name:ELLEN
Middle Name:CURTIS
Last Name:ODZA
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1148
Mailing Address - Street 2:
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501-0117
Mailing Address - Country:US
Mailing Address - Phone:510-303-9345
Mailing Address - Fax:270-714-9345
Practice Address - Street 1:2233 SANTA CLARA AVE
Practice Address - Street 2:SUITE 2A
Practice Address - City:ALAMEDA
Practice Address - State:CA
Practice Address - Zip Code:94501-4416
Practice Address - Country:US
Practice Address - Phone:510-303-9345
Practice Address - Fax:270-714-9345
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-19
Last Update Date:2009-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 42947106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist