Healthcare Provider Details

I. General information

NPI: 1205019809
Provider Name (Legal Business Name): JENNIFER MARIE SEAY DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/06/2007
Last Update Date: 08/15/2023
Certification Date: 08/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1414 PARK ST
PASO ROBLES CA
93446-2160
US

IV. Provider business mailing address

408 HIGUERA ST STE 200
SAN LUIS OBISPO CA
93401-6135
US

V. Phone/Fax

Practice location:
  • Phone: 805-226-0975
  • Fax: 805-226-0909
Mailing address:
  • Phone: 805-788-0805
  • Fax: 805-788-0845

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number34280
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: