Healthcare Provider Details

I. General information

NPI: 1578985370
Provider Name (Legal Business Name): SHELBI UYEHARA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/13/2014
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3101 N CENTRAL AVE STE 1186
PHOENIX AZ
85012-2841
US

IV. Provider business mailing address

3101 N CENTRAL AVE STE 1186
PHOENIX AZ
85012-2841
US

V. Phone/Fax

Practice location:
  • Phone: 480-409-5456
  • Fax:
Mailing address:
  • Phone: 480-939-9307
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW-23916
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: