Healthcare Provider Details

I. General information

NPI: 1245478692
Provider Name (Legal Business Name): DEBORAH SEFFINGER PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/22/2009
Last Update Date: 01/12/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10722 ARROW ROUTE SUITE 314
RANCHO CUCAMONGA CA
91730-4811
US

IV. Provider business mailing address

10722 ARROW ROUTE SUITE 314
RANCHO CUCAMONGA CA
91730-4811
US

V. Phone/Fax

Practice location:
  • Phone: 909-484-8888
  • Fax: 909-581-0920
Mailing address:
  • Phone: 909-484-8888
  • Fax: 909-581-0920

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY 22246
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: