Healthcare Provider Details

I. General information

NPI: 1487328662
Provider Name (Legal Business Name): IVONNA MAE SEATON NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2021
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7223 CHURCH ST # C-1
HIGHLAND CA
92346-5869
US

IV. Provider business mailing address

869 W ASTER ST
UPLAND CA
91786-2226
US

V. Phone/Fax

Practice location:
  • Phone: 909-425-3939
  • Fax:
Mailing address:
  • Phone: 425-318-2761
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95170989
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number95017587
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number60082679
License Number StateWA
# 4
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP61181964
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: