Healthcare Provider Details

I. General information

NPI: 1386755684
Provider Name (Legal Business Name): SHEILA VAHNINGLE WELSH LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SHEILA VAHNINGLE BOWRY MSW

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11301 WILSHIRE BLVD
LOS ANGELES CA
90073-1003
US

IV. Provider business mailing address

PO BOX 84108
LOS ANGELES CA
90073-0108
US

V. Phone/Fax

Practice location:
  • Phone: 310-478-3711
  • Fax: 310-268-4849
Mailing address:
  • Phone: 310-478-3711
  • Fax: 310-268-4849

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number17433
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number17433
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number17433
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number17433
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code322D00000X
TaxonomyEmotionally Disturbed Childrens' Residential Treatment Facility
License Number17433
License Number StateCA
# 6
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number17433
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: