Healthcare Provider Details

I. General information

NPI: 1942933767
Provider Name (Legal Business Name): BRANDI SEAMAN PH.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2022
Last Update Date: 07/08/2022
Certification Date: 07/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11500 W OLYMPIC BLVD STE 640
LOS ANGELES CA
90064-1525
US

IV. Provider business mailing address

11500 W OLYMPIC BLVD STE 640
LOS ANGELES CA
90064-1525
US

V. Phone/Fax

Practice location:
  • Phone: 424-225-1845
  • Fax: 310-933-4803
Mailing address:
  • Phone: 424-225-1845
  • Fax: 310-933-4803

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number33421
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: