Provider Demographics
NPI:1730397258
Name:SEYMOUR, DAVID RICHARD (MFT)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:RICHARD
Last Name:SEYMOUR
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20430 BRIAN WAY STE 2
Mailing Address - Street 2:
Mailing Address - City:TEHACHAPI
Mailing Address - State:CA
Mailing Address - Zip Code:93561-6762
Mailing Address - Country:US
Mailing Address - Phone:415-717-6926
Mailing Address - Fax:
Practice Address - Street 1:1901 BRUNDAGE LN
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93304-2848
Practice Address - Country:US
Practice Address - Phone:661-869-1074
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2015-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC39354106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist