Most Relevant Information
Provider Data
| NPI Number: | 1003455411 |
| Provider Name: | ELYSE JULIA MALCOLM |
| Entity Type: | Individual |
| Taxonomy Code: | 171M00000X |
| Specialty: | Case Manager/Care Coordinator |
| License Number: |
Most Important Dates
| Enumeration Date: | 01/02/2020 |
| Last Updated: | 10/10/2023 |
Provider Practice Location
251 LLEWELLYN AVE
CAMPBELL
CA
950081940
Practice Location Phone/Fax
| Phone: | 6693029756 |
| Fax: |
Provider Mailing Location
251 LLEWELLYN AVE
CAMPBELL
CA
950081940
Provider Mailing Phone/Fax
| Phone: | 6693029756 |
| Fax: |