Provider Demographics
NPI:1902934417
Name:HAIG, SETA S (MS)
Entity Type:Individual
Prefix:MS
First Name:SETA
Middle Name:S
Last Name:HAIG
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1858 CALLE FORTUNA
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91208-3024
Mailing Address - Country:US
Mailing Address - Phone:818-554-1208
Mailing Address - Fax:
Practice Address - Street 1:1540 E COLORADO ST
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91205-1514
Practice Address - Country:US
Practice Address - Phone:818-244-7257
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2011-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC48175106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist