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General NPI Number Information
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NPI Number | 1346324332
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Entity Type | Individual
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Provider Name | PHILIP CISNEROS-SEIBEL PHD
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Gender | Male
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 02/19/2025
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Provider Practice Location Address
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Address Line | 3734 6TH AVE
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City | SAN DIEGO
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State | CA
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Zip | 92103-4317
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Country | US
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Telephone | 302-128-7063
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Fax |
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Provider Business Mailing Address
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Address Line | 845 FORT STOCKTON DR UNIT 514
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City | SAN DIEGO
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State | CA
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Zip | 92103-6707
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Country | US
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Telephone | 330-212-8706
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Fax |
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 30970
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 4558
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License Number State | OH
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