Provider Demographics
NPI:1891408134
Name:WELSH, CONRAD LOGAN (EMT)
Entity type:Individual
Prefix:
First Name:CONRAD
Middle Name:LOGAN
Last Name:WELSH
Suffix:
Gender:M
Credentials:EMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17060 MONTEREY ST
Mailing Address - Street 2:
Mailing Address - City:MORGAN HILL
Mailing Address - State:CA
Mailing Address - Zip Code:95037-3636
Mailing Address - Country:US
Mailing Address - Phone:408-876-4284
Mailing Address - Fax:
Practice Address - Street 1:17060 MONTEREY ST
Practice Address - Street 2:
Practice Address - City:MORGAN HILL
Practice Address - State:CA
Practice Address - Zip Code:95037-3636
Practice Address - Country:US
Practice Address - Phone:408-876-4284
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-02
Last Update Date:2025-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE157049146N00000X
171M00000X, 225400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
No146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic
No171M00000XOther Service ProvidersCase Manager/Care Coordinator