Healthcare Provider Details

I. General information

NPI: 1952205296
Provider Name (Legal Business Name): TIMOTHY STEPHEN SEDGLEY RN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2026
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 N EL CIELO RD
PALM SPRINGS CA
92262-6914
US

IV. Provider business mailing address

275 N EL CIELO RD
PALM SPRINGS CA
92262-6914
US

V. Phone/Fax

Practice location:
  • Phone: 760-328-4499
  • Fax:
Mailing address:
  • Phone: 760-328-4499
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number551869
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: