Provider Demographics
NPI:1508132820
Name:ELLOWAY, ARLEEN (NP-C)
Entity type:Individual
Prefix:MRS
First Name:ARLEEN
Middle Name:
Last Name:ELLOWAY
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:ARLEEN
Other - Middle Name:
Other - Last Name:STIENSTRA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:3675 RUFFIN RD STE 330
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-1870
Mailing Address - Country:US
Mailing Address - Phone:602-505-1924
Mailing Address - Fax:
Practice Address - Street 1:3675 RUFFIN RD STE 330
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-1870
Practice Address - Country:US
Practice Address - Phone:858-289-7857
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-30
Last Update Date:2025-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP4358363L00000X
DCNP500015513363L00000X
CA95011100363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner