Provider Demographics
NPI:1164761177
Name:SIEH, WILLIAM POUATE
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:POUATE
Last Name:SIEH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1085 RANCHERO WAY
Mailing Address - Street 2:APT # 7
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95117-3109
Mailing Address - Country:US
Mailing Address - Phone:408-600-7095
Mailing Address - Fax:
Practice Address - Street 1:1085 RANCHERO WAY
Practice Address - Street 2:APT # 7
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95117-3109
Practice Address - Country:US
Practice Address - Phone:408-600-7095
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-11
Last Update Date:2013-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health