Provider Demographics
NPI:1316746423
Name:SHEEHAN, ELLEN (ASW)
Entity type:Individual
Prefix:
First Name:ELLEN
Middle Name:
Last Name:SHEEHAN
Suffix:
Gender:
Credentials:ASW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 1/4 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SEAL BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90740-6318
Mailing Address - Country:US
Mailing Address - Phone:323-546-4414
Mailing Address - Fax:
Practice Address - Street 1:972 GOODRICH BLVD
Practice Address - Street 2:
Practice Address - City:COMMERCE
Practice Address - State:CA
Practice Address - Zip Code:90022-4114
Practice Address - Country:US
Practice Address - Phone:818-434-5380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-11
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW125860104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker