Provider Demographics
NPI:1003197062
Name:SEYMOUR, BARBARA LEE (LAC)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:LEE
Last Name:SEYMOUR
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:665 SAN RODOLFO DR
Mailing Address - Street 2:#124/175
Mailing Address - City:SOLANA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92075-2047
Mailing Address - Country:US
Mailing Address - Phone:858-342-1333
Mailing Address - Fax:
Practice Address - Street 1:136 N ACACIA AVE
Practice Address - Street 2:
Practice Address - City:SOLANA BEACH
Practice Address - State:CA
Practice Address - Zip Code:92075-1182
Practice Address - Country:US
Practice Address - Phone:858-342-1333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-05
Last Update Date:2011-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC11100171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist