Healthcare Provider Details

I. General information

NPI: 1659664118
Provider Name (Legal Business Name): LEE SEIDER OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2011
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13330 VIA TRESCA UNIT 3
SAN DIEGO CA
92129-5146
US

IV. Provider business mailing address

13330 VIA TRESCA UNIT 3
SAN DIEGO CA
92129-5146
US

V. Phone/Fax

Practice location:
  • Phone: 858-444-5549
  • Fax:
Mailing address:
  • Phone: 858-444-5549
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License NumberOT 9733
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: