Healthcare Provider Details

I. General information

NPI: 1902813082
Provider Name (Legal Business Name): JOANIE M SEIDEL MFT, CT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/02/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4601 DRY CREEK ROAD
NAPA CA
94558-2864
US

IV. Provider business mailing address

4601 DRY CREEK ROAD
NAPA CA
94558-9595
US

V. Phone/Fax

Practice location:
  • Phone: 707-253-7513
  • Fax: 707-253-7513
Mailing address:
  • Phone: 707-253-7513
  • Fax: 707-253-7513

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number33059
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: