Provider Demographics
NPI:1659571024
Name:SEELEY, CHERIDAH JONES (PAC)
Entity type:Individual
Prefix:MRS
First Name:CHERIDAH
Middle Name:JONES
Last Name:SEELEY
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42357 50TH ST W STE 107
Mailing Address - Street 2:
Mailing Address - City:QUARTZ HILL
Mailing Address - State:CA
Mailing Address - Zip Code:93536-3529
Mailing Address - Country:US
Mailing Address - Phone:661-943-6455
Mailing Address - Fax:661-718-1580
Practice Address - Street 1:42357 50TH ST W STE 107
Practice Address - Street 2:
Practice Address - City:QUARTZ HILL
Practice Address - State:CA
Practice Address - Zip Code:93536-3529
Practice Address - Country:US
Practice Address - Phone:661-943-6455
Practice Address - Fax:661-718-1580
Is Sole Proprietor?:No
Enumeration Date:2007-07-23
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA13993363A00000X, 363AM0700X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical