Provider Demographics
NPI:1740056621
Name:SCHELTGEN, EMILY ALLISON (AMFT)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:ALLISON
Last Name:SCHELTGEN
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 MONTROSE AVE UNIT 3
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:CA
Mailing Address - Zip Code:91021-7002
Mailing Address - Country:US
Mailing Address - Phone:818-330-5015
Mailing Address - Fax:
Practice Address - Street 1:230 N MARYLAND AVE STE 303
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91206-4281
Practice Address - Country:US
Practice Address - Phone:818-330-5015
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-30
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA138764106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist