Most Relevant Information
Provider Data
| NPI Number: | 1003833989 |
| Provider Name: | ELLEN K. PAYNE MA, ATC, CSCS |
| Entity Type: | Individual |
| Taxonomy Code: | 2255A2300X |
| Specialty: | Specialist/Technologist |
| License Number: |
Most Important Dates
| Enumeration Date: | 07/16/2006 |
| Last Updated: | 07/08/2007 |
Provider Practice Location
302 PORTOLA RD
PORTOLA VALLEY
CA
940287851
Practice Location Phone/Fax
| Phone: | 6508516128 |
| Fax: |
Provider Mailing Location
PO BOX 247
CUPERTINO
CA
950150247
Provider Mailing Phone/Fax
| Phone: | 4083487448 |
| Fax: |