Healthcare Provider Details

I. General information

NPI: 1932069721
Provider Name (Legal Business Name): THOMAS DAVID SEIFERT CADC-I
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/13/2025
Last Update Date: 01/08/2026
Certification Date: 01/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1640 SUPERIOR AVE
COSTA MESA CA
92627-3652
US

IV. Provider business mailing address

575 W 19TH ST APT H172
COSTA MESA CA
92627-5052
US

V. Phone/Fax

Practice location:
  • Phone: 916-358-0757
  • Fax:
Mailing address:
  • Phone: 916-358-0757
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCI49561125
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: