Provider Demographics
NPI:1720289820
Name:SEHLMEYER, ELLEN MARLENE (PT , MFT)
Entity type:Individual
Prefix:MS
First Name:ELLEN
Middle Name:MARLENE
Last Name:SEHLMEYER
Suffix:
Gender:F
Credentials:PT , MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5358
Mailing Address - Street 2:
Mailing Address - City:LOS ALAMITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90721-5358
Mailing Address - Country:US
Mailing Address - Phone:562-209-2771
Mailing Address - Fax:
Practice Address - Street 1:10650 REAGAN ST
Practice Address - Street 2:
Practice Address - City:LOS ALAMITOS
Practice Address - State:CA
Practice Address - Zip Code:90720-2472
Practice Address - Country:US
Practice Address - Phone:562-961-3581
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-29
Last Update Date:2010-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12354225100000X
CA45409106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist