Provider Demographics
NPI:1083324701
Name:SEPPINNI, OLIVIA LEE (LMT)
Entity Type:Individual
Prefix:MS
First Name:OLIVIA
Middle Name:LEE
Last Name:SEPPINNI
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:5714 LONETREE BLVD
Mailing Address - Street 2:
Mailing Address - City:ROCKLIN
Mailing Address - State:CA
Mailing Address - Zip Code:95765-3734
Mailing Address - Country:US
Mailing Address - Phone:916-259-2510
Mailing Address - Fax:916-259-0073
Practice Address - Street 1:5714 LONETREE BLVD
Practice Address - Street 2:
Practice Address - City:ROCKLIN
Practice Address - State:CA
Practice Address - Zip Code:95765-3734
Practice Address - Country:US
Practice Address - Phone:916-259-2510
Practice Address - Fax:916-259-0073
Is Sole Proprietor?:No
Enumeration Date:2022-12-05
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA92238225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist