Healthcare Provider Details

I. General information

NPI: 1730397258
Provider Name (Legal Business Name): DAVID RICHARD SEYMOUR MFT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2007
Last Update Date: 11/02/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 BRUNDAGE LN
BAKERSFIELD CA
93304-2848
US

IV. Provider business mailing address

20430 BRIAN WAY STE 2
TEHACHAPI CA
93561-6762
US

V. Phone/Fax

Practice location:
  • Phone: 661-869-1074
  • Fax:
Mailing address:
  • Phone: 415-717-6926
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFC39354
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: