1851659056 NPI number — PATRICIA JEAN SEYMOUR PH.D., SLP

Table of content: PATRICIA JEAN SEYMOUR PH.D., SLP (NPI 1851659056)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851659056 NPI number — PATRICIA JEAN SEYMOUR PH.D., SLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SEYMOUR
Provider First Name:
PATRICIA
Provider Middle Name:
JEAN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PH.D., SLP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1851659056
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/25/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
CSUN LANGUAGE SPEECH AND HEARING CTR
Provider Second Line Business Mailing Address:
18111 NORDHOFF STREET
Provider Business Mailing Address City Name:
NORTHRIDGE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91330-8288
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
818-677-2856
Provider Business Mailing Address Fax Number:
818-677-5952

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CSUN LANGUAGE SPEECH AND HEARING CTR
Provider Second Line Business Practice Location Address:
18111 NORDHOFF STREET
Provider Business Practice Location Address City Name:
NORTHRIDGE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91330-8288
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-677-2856
Provider Business Practice Location Address Fax Number:
818-677-5952
Provider Enumeration Date:
04/25/2012

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X , with the licence number:  SP15776 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)