Healthcare Provider Details

I. General information

NPI: 1164681391
Provider Name (Legal Business Name): THERESA LYNN SEFFRIN BA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2008
Last Update Date: 01/19/2023
Certification Date: 01/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39782 AVENIDA MIGUEL OESTE
MURRIETA CA
92563-5294
US

IV. Provider business mailing address

39782 AVENIDA MIGUEL OESTE
MURRIETA CA
92563-5294
US

V. Phone/Fax

Practice location:
  • Phone: 505-629-2762
  • Fax:
Mailing address:
  • Phone: 505-629-2762
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: