Healthcare Provider Details

I. General information

NPI: 1285152108
Provider Name (Legal Business Name): DR. PRIYAM SETHI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2017
Last Update Date: 02/07/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2333 S MOONEY BLVD
VISALIA CA
93277-6228
US

IV. Provider business mailing address

1049 N WOODLAND ST APT 102
VISALIA CA
93291-4875
US

V. Phone/Fax

Practice location:
  • Phone: 877-960-3426
  • Fax:
Mailing address:
  • Phone: 408-680-6685
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number103219
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: