Healthcare Provider Details

I. General information

NPI: 1437015187
Provider Name (Legal Business Name): SEEMA SUNIL PANICKER FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/26/2025
Last Update Date: 12/26/2025
Certification Date: 12/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 E COMMONWEALTH AVE STE 100
FULLERTON CA
92832-1905
US

IV. Provider business mailing address

13728 LUCAS LN
CERRITOS CA
90703-1450
US

V. Phone/Fax

Practice location:
  • Phone: 714-572-3900
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95037063
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: