Healthcare Provider Details

I. General information

NPI: 1679706477
Provider Name (Legal Business Name): SARAH MARGARET SHEALY CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2009
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1849 SAWTELLE BLVD STE 610
LOS ANGELES CA
90025-7013
US

IV. Provider business mailing address

1524 YALE ST APT 2
SANTA MONICA CA
90404-3605
US

V. Phone/Fax

Practice location:
  • Phone: 310-806-0404
  • Fax: 424-548-8748
Mailing address:
  • Phone: 310-806-0404
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number1289
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: