Healthcare Provider Details

I. General information

NPI: 1770603060
Provider Name (Legal Business Name): HAROLD L SEYMOUR PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/30/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5740 N PALM AVE STE 105
FRESNO CA
93704-1800
US

IV. Provider business mailing address

5740 N PALM AVE STE 105
FRESNO CA
93704-1800
US

V. Phone/Fax

Practice location:
  • Phone: 559-431-1900
  • Fax: 559-431-1951
Mailing address:
  • Phone: 559-431-1900
  • Fax: 559-431-1951

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY10400
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: