Healthcare Provider Details

I. General information

NPI: 1144176900
Provider Name (Legal Business Name): SONIA CHELSVIG PPS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/05/2026
Last Update Date: 03/05/2026
Certification Date: 03/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9229 PENTLAND ST
TEMPLE CITY CA
91780-3736
US

IV. Provider business mailing address

517 COOLIDGE DR
SAN GABRIEL CA
91775-2211
US

V. Phone/Fax

Practice location:
  • Phone: 626-548-5121
  • Fax:
Mailing address:
  • Phone: 626-975-6746
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number260029771
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: