Healthcare Provider Details

I. General information

NPI: 1033573787
Provider Name (Legal Business Name): SCOTT SEOMIN LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2016
Last Update Date: 04/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8235 SANTA MONICA BLVD STE 302
WEST HOLLYWOOD CA
90046-5969
US

IV. Provider business mailing address

8235 SANTA MONICA BLVD STE 302
WEST HOLLYWOOD CA
90046-5969
US

V. Phone/Fax

Practice location:
  • Phone: 310-892-4284
  • Fax: 323-366-2966
Mailing address:
  • Phone: 310-892-4284
  • Fax: 323-366-2966

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT90578
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: