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General NPI Number Information
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NPI Number | 1457038630
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Entity Type | Individual
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Provider Name | JALENE ELLIS VINCENT WELCH LMFT
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Gender | Female
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Dates
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Enumeration Date | 06/29/2023
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Last Update Date | 01/05/2026
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Provider Practice Location Address
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Address Line | 21125 CENTRE POINTE PKWY
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City | SANTA CLARITA
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State | CA
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Zip | 91350-2994
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Country | US
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Telephone | 855-435-3801
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 44416
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City | LEMON COVE
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State | CA
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Zip | 93244-0416
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Country | US
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Telephone | 559-345-5112
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 159482
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License Number State | CA
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