MEDICARE: CHELSEA MARIE VIELHAUER MSW, LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	LCSW114678	CA

General Provider Information

NPI Number	:	1912682840
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHELSEA MARIE VIELHAUER MSW, LCSW

Provider Business Mailing Address
First Line	:	1174 VIA VERDE UNIT 1011
Second Line	:
City	:	SAN DIMAS
State	:	CA
Zip	:	91773-4401
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	400 CONTINENTAL BLVD
Second Line	:
City	:	EL SEGUNDO
State	:	CA
Zip	:	90245-5076
Country	:	US
Telephone Number	:	310-648-0700
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/19/2023
Last Update Date	:	04/11/2026

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