NPI Code Detail JSON Logo

1124108071 NPI number — SUZANNE ADELE SEALEY MPT

NPI Number: 1124108071
Health Care Provider/Practitioner: SUZANNE ADELE SEALEY MPT

Information about “1124108071” NPI (SUZANNE ADELE SEALEY MPT) exists in 1124108071 in HTML format HTML  |  1124108071 in plain Text format TXT  |  1124108071 in PDF (Portable Document Format) PDF  |  1124108071 in an XML format XML  formats.

NPI Number : 1124108071 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1124108071",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "SEALEY",
    "FirstName": "SUZANNE",
    "MiddleName": "ADELE",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "MPT",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "425 HIGHLAND DR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "SANTA MARIA",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "93455-5515",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "805-934-0543",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "880 OAK PARK BLVD",
    "SecondLinePracticeLocationAddress": "SUITE 202",
    "PracticeLocationAddressCityName": "ARROYO GRANDE",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "93420-1821",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "805-473-7499",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "10/16/2006",
    "LastUpdateDate": "07/08/2007",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "174400000X",
        "TaxonomyName": "Specialist",
        "LicenseNumber": "26553",
        "LicenseNumberStateCode": "CA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.