NPI Code Detail JSON Logo

1336161231 NPI number — MANUEL LINCOLN SELYA PH.D. PSYCHOLOGY

NPI Number: 1336161231
Health Care Provider/Practitioner: MANUEL LINCOLN SELYA PH.D. PSYCHOLOGY

Information about “1336161231” NPI (MANUEL LINCOLN SELYA PH.D. PSYCHOLOGY) exists in 1336161231 in HTML format HTML  |  1336161231 in plain Text format TXT  |  1336161231 in PDF (Portable Document Format) PDF  |  1336161231 in an XML format XML  formats.

NPI Number : 1336161231 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1336161231",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "SELYA",
    "FirstName": "MANUEL",
    "MiddleName": "LINCOLN",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "PH.D. PSYCHOLOGY",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "SELYA",
    "OtherFirstName": "EMANUEL",
    "OtherMiddleName": "LINCOLN",
    "OtherNamePrefix": "DR.",
    "OtherNameSuffix": null,
    "OtherCredential": "PH.D. PSYCHOLOGY",
    "OtherLastNameTypeCode": "2",
    "FirstLineMailingAddress": "120 CRESCENT BAY DR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "LAGUNA BEACH",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "92651-1321",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "949-929-1143",
    "MailingAddressFaxNumber": "949-494-6255",
    "FirstLinePracticeLocationAddress": "4199 CAMPUS DR",
    "SecondLinePracticeLocationAddress": "350",
    "PracticeLocationAddressCityName": "IRVINE",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "92612-4684",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "949-929-1143",
    "PracticeLocationAddressFaxNumber": "949-494-6255",
    "EnumerationDate": "07/23/2006",
    "LastUpdateDate": "07/08/2007",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "103TC0700X",
        "TaxonomyName": "Clinical Psychologist",
        "LicenseNumber": "PSY 7600",
        "LicenseNumberStateCode": "CA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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