Healthcare Provider Details

I. General information

NPI: 1699137968
Provider Name (Legal Business Name): MAUREEN SEIFERT LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2016
Last Update Date: 03/24/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

630 AZALEA AVE
REDDING CA
96002-0217
US

IV. Provider business mailing address

765 GOLD ST
REDDING CA
96001-2035
US

V. Phone/Fax

Practice location:
  • Phone: 530-945-3494
  • Fax:
Mailing address:
  • Phone: 530-945-3494
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number70799
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: