Healthcare Provider Details

I. General information

NPI: 1720289820
Provider Name (Legal Business Name): ELLEN MARLENE SEHLMEYER P.T. , MFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/29/2007
Last Update Date: 01/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10650 REAGAN ST
LOS ALAMITOS CA
90720-2472
US

IV. Provider business mailing address

PO BOX 5358
LOS ALAMITOS CA
90721-5358
US

V. Phone/Fax

Practice location:
  • Phone: 562-961-3581
  • Fax:
Mailing address:
  • Phone: 562-209-2771
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number12354
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number45409
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: