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General NPI Number Information
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NPI Number | 1164791109
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Entity Type | Individual
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Provider Name | ROBERT RADCLIFFE SEYMOUR LMFCT
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Gender | Male
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Dates
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Enumeration Date | 12/20/2011
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Last Update Date | 12/20/2011
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Provider Practice Location Address
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Address Line | 17705 HALE AVENUE SUITE H2
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City | MORGAN HILL
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State | CA
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Zip | 95037
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Country | US
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Telephone | 408-778-2604
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Fax | 408-778-2126
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Provider Business Mailing Address
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Address Line | 17705 HALE AVE SUITE H2
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City | MORGAN HILL
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State | CA
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Zip | 95037-4340
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Country | US
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Telephone | 408-778-2604
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Fax | 408-778-2126
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | M19146
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License Number State | CA
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