Healthcare Provider Details

I. General information

NPI: 1548031362
Provider Name (Legal Business Name): 7 SEAS MEDICAL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2024
Last Update Date: 02/21/2025
Certification Date: 02/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5015 TWILIGHT CANYON RD UNIT B
YORBA LINDA CA
92887-3957
US

IV. Provider business mailing address

5015 TWILIGHT CANYON RD UNIT B
YORBA LINDA CA
92887-3957
US

V. Phone/Fax

Practice location:
  • Phone: 562-556-5509
  • Fax: 310-432-2428
Mailing address:
  • Phone: 562-556-5509
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MR. MATTHEW FASTIGGI
Title or Position: OWNER
Credential:
Phone: 562-556-5509